Bolin Jane Nelson, Buchanan Robert J, Smith Scott R
Department of Health Policy and Management, School of Rural Public Health, The Texas A&M University System Health Sciences Center, College Station, 77843-1266, USA.
Am J Manag Care. 2002 Nov;8(11):977-85.
This study analyzes the results of 2 surveys sent to state insurance commissioners that focused on policies regulating conventional health insurance and managed care organizations (MCOs) during 2000. Surveys were returned by 49 states and the District of Columbia. Several states have implemented regulations mandating prescription drug coverage. In addition, some states now require health insurers and MCOs to cover the medical care associated with experimental medications and treatments. Some states have also created laws allowing beneficiaries to sue their health insurer or MCO for damages caused by denial of care. These state policies provide a rich source of data for federal policy makers to analyze as they consider new patient protection legislation and amendments to the Employee Retirement Income Security Act.
本研究分析了发给州保险专员的两份调查问卷的结果，这两份问卷聚焦于2000年期间规范传统医疗保险和管理式医疗组织（MCO）的政策。49个州和哥伦比亚特区回复了问卷。几个州已实施要求提供处方药保险的规定。此外，一些州现在要求健康保险公司和管理式医疗组织涵盖与实验性药物和治疗相关的医疗护理。一些州还制定了法律，允许受益人起诉其健康保险公司或管理式医疗组织，要求赔偿因拒绝提供护理而造成的损失。这些州政策为联邦政策制定者在考虑新的患者保护立法和对《雇员退休收入保障法》的修订时提供了丰富的数据分析来源。
