HMO CONSUMER GUIDE - H.B. 5572 (H-1): REVISED COMMITTEE SUMMARY
House Bill 5572 (Substitute H-1 as passed by the House)
Sponsor: Representative Gary Woronchak
House Committee: Health Policy
Senate Committee: Health Policy
CONTENT
The bill would amend the Insurance Code to require the Commission of Financial and Insurance Services to prepare a consumer guide to health maintenance organizations (HMOs). The Commissioner would have to publish the guide beginning on January 1, 2001, and annually thereafter.
The consumer guide would have to include all of the following for the most recent year and for the immediately preceding year for which the information was available:
-- The national accreditation status of, and any limitation on accreditation for, each HMO.
-- Measurements of the quality of care provided by each HMO, as required by the Commissioner, including at least the following health employer data information set categories: child and adolescent care; maternity care; cardiac care; staying healthy; member satisfaction; and women's health.
-- The toll-free telephone number at the Office of Financial and Insurance Services that consumers could call to request the consumer guide and make inquiries and complaints about HMOs.
-- A summary for each HMO of the report that would have to be provided to the Commissioner under Section 23 of the "Patient's Right to Independent Review Act", proposed by House Bill 5576. (Under Section 23 of House Bill 5576 (H-3), an independent review organization assigned to conduct an external review of an adverse determination regarding health care service, would have to submit to the Commissioner an annual report containing prescribed information.)
The Commissioner could request, and an HMO and the Department of Community Health would have to provide in a timely manner, audited health employer information set data and other information that the Commissioner needed to prepare the consumer guide.
The annual consumer guide would have to be written in plain English and be presented in a manner that facilitated comparisons among individual HMOs. The Commissioner would have to distribute the guide to members of the public upon request, and provide access to the guide through the Internet.
Proposed MCL 500.3580 - Legislative Analyst: G. Towne
FISCAL IMPACT
The bill would require the Commissioner of Financial and Insurance Services to design and distribute a consumer guide to HMOs. This additional responsibility would result in increased costs for the Department, for which no estimates are currently available.
- Fiscal Analyst: M. TyszkiewiczS9900\s5572sb
This analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent.