MANAGED CARE March 1998. ©1998 Stezzi Communications
The Indiana Senate last month approved a bill that would expand the choice of physicians for nearly 800,000 HMO enrollees.
The bill, which passed by a bipartisan 35-15 vote, would allow patients with special needs to choose a specialist as their primary physician, let patients see a physician outside a company's network in some circumstances, require HMOs to offer a point-of-service option, mandate that managed care companies continually update their lists of approved providers and require plans to pay for nonformulary drugs when a physician decides they are medically necessary.
Opponents say the bill, now under consideration in the House, would boost costs and could cause some people to lose coverage. Critics also suggest it could drive smaller plans out of business because of the expense of compliance.