ANNAPOLIS – A bill to make medical directors of managed health plans responsible for their decisions passed in the Senate by a large margin Friday, but not without a fight.
Two leading Democrats offered lengthy complaints about the bill’s costs and alleged it would make scapegoats of medical directors.
Under the bill, HMO medical directors could be fined and lose their licenses to practice medicine in the state for denying a covered service if a patient is harmed by that denial.
Under current law, the medical director could not remain in that job in Maryland, but could continue to practice medicine here.
The bill passed, 38-9, but with strong opposition from two prominent legislators.
Sen. Thomas L. Bromwell, D-Baltimore County, complained the bill could raise costs for the State Employee Health Benefits Plan and Medicaid. Fiscal analysis by Legislative Services predicted only minimal impact.
Bromwell also argued the money would be better spent on providing care for the uninsured or underinsured.
“Clinics in Baltimore are sending poor people away because we have not put money in the system,” he said.
Bromwell referred to the bill’s sponsor, Sen. Paula Colodny Hollinger, D- Baltimore County, as a “pit bull on this issue.”
Hollinger, a former nurse, replied “I’m a pit bull, but I don’t bite . . . the only people who have been bitten are the ones who have not gotten adequate health care.”
Sen. Walter M. Baker, D-Cecil, also opposed the bill, saying doctors pushed for the measure to make sure they get paid for the medical procedures they perform.
“I do hear complaints about HMO’s,” Baker said, “but where do they come from? They come from doctors.”
A panel of 15 doctors appointed by the governor, called the Board of Physician Quality Assurance, would have the authority to determine and punish wrongdoing by HMO medical directors. The board can reprimand, suspend the license to practice, or issue fines up to $50,000.
“Why should these doctors . . . be in a power position to force a medical director to make a decision,” Baker said.
Some insurers worry the bill would chill any restraint of coverage. Medical directors would be afraid to disapprove any procedure for fear of disciplinary action, according to D. Robert Enten, Maryland Association of Health Plans lobbyist.
An identical bill was filed in the House of Delegates by Kevin Kelly, D- Allegany, and it has more than 90 co-sponsors. That gives it plenty of votes to pass, but Hollinger isn’t holding her breath. Similar bills have been introduced in the previous two sessions and passed in the Senate, but died both times in the House Environmental Matters Committee.
House Speaker Casper Taylor, D-Allegany, “hates it,” Hollinger said. “I have very strong feelings about (this bill), but I’m not going to respond to her comments,” Taylor said. He declined to clarify his position on the bill. – 30 – CNS-2-9-01