The Department of Health and Human Services has published regulations describing how health plans can become part of the Medicare+Choice program, giving managed care organizations the go-ahead to apply for Medicare+Choice certification. The regulations provide for an annual open enrollment period (see a related story on page 42), much like managed care plans provide to employers. The regulations extend President Clinton's Patient Bill of Rights to all Medicare enrollees and shorten the time frame for initial decisions on patient appeals from 60 to 14 days.... Managed Medicare enrollment is growing dramatically, says a Lewin Group study. Lewin's head count shows Medicare managed care enrollment more than doubled between December 1995 and December 1997.... More than 40 percent of physicians are either very or somewhat dissatisfied with Medicare HMOs they contract with, according to a new HHS report. Some physicians complained that Medicare HMOs restrict access to care, but overall, physicians felt that Medicare HMO enrollees receive good care.... Medical privacy legislation may be enacted after all. Legislators don't want to cede authority to HHS to promulgate regulations next August, the deadline for Congress to act. And the buzz is that health insurance associations wouldn't mind uniform national standards governing patient medical records.