ANNAPOLIS – Gov. Parris N. Glendening signed his Patients’ Bill of Rights into law Tuesday claiming health care users now are assured of “quick, safe and appropriate access to medical treatment,” but not everyone is sharing that optimism.
One critic charged that the governor’s bill “does not mean very much” and will “give Maryland patients (only) slightly more rights” because it is weaker than the original.
The bill was designed to expand rights for managed care patients, providing them with more flexible access to specialists and drugs and the option of staying in a hospital two nights after undergoing a mastectomy or testicle removal. It does all but the latter, but was amended several times during the General Assembly session, and some critics don’t care for the compromises.
The provision that inspired the most legislative debate would have required insurers to allow mastectomy and testicle removal patients to remain in the hospital 48 hours after surgery.
But House members said a physician’s right to make care decisions was abrogated by the provision, and it would drive up costs. Senate members and the governor felt patients, particularly women, were being rushed out of hospitals and needed legislative support to stay longer.
The final version requires insurers to pay for one home health care visit for mastectomy and testicle removal patients who are released earlier than 48 hours following surgery.
“These so-called `drive-through mastectomies’ are outrageous. I thought 48 hours was reasonable,” Glendening said recently, adding he was satisfied with the alternative.
But Charlie Gerhardt, president of the Maryland Patients’ Rights Advocacy Group, did not approve of that alternative or the removal of a provision to allow specialists to be primary care providers for patients with serious or chronic illnesses.
“As a patients’ bill of rights, it’s a disgrace – it never lived up to its name,” Gerhardt said. “It just gives politicians a chance to say, `We made another improvement in the health-care environment,’ and I don’t think that’s the case.”
While Gerhardt praised the compromise on specialist care – it allows seriously ill patients to see a specialist several times with only one referral – he questioned another that requires insurance companies to cover medically necessary medication not on their approved list. The bill doesn’t specify how much of the cost will be covered, he said.
“I worry that the plan might pay $30 and the patient $130,” he said.
Ray Feldmann, press secretary for the governor, defended the bill’s intentions.
“Overall, this is a good, strong bill that helps to create better balance between the needs of the patients and the needs of the managed care industry,” he said.
Dr. Robert Lyles, an anesthesiologist and legislative committee chairman for MedChi, Maryland’s physician organization, supported the bill, saying it will make the process easier for patients and give some power back to doctors.
“I think what we are doing here is giving patients a little bit of what they used to have – rights – and taking the decision power away from the medical director who doesn’t see the patient at all.”
Maryland Insurance Commissioner Steve Larsen supported the part of the bill making his department the central point for health information. It will cut through patient confusion, he said. His agency has begun planning and will hire a staff member this summer to act as ombudsman.
Both Larsen and Department of Health and Mental Hygiene Secretary Martin Wasserman also are satisfied with the standing specialist referral provision.
“We hope this bill will continue to provide Maryland patients with quality care,” Wasserman said. “No law is perfect, but I think we should all be optimistic.”