Rehrmann backs effort on HMO discipline


Hoping to capitalize on an issue resonating loudly with many voters, Democratic gubernatorial candidate Eileen M. Rehrmann said yesterday she supports legislative efforts to discipline medical directors of HMOs for inappropriate medical-care decisions.

The measure, which is opposed by health maintenance organizations, is needed to ensure that patients in managed care receive the care they need, Rehrmann said.

A similar proposal has prompted contentious fights in the General Assembly the last four years. Rehrmann's stance could put her in conflict with Gov. Parris N. Glendening, although he has not taken a position on the proposal.

Another Democratic candidate, Montgomery County businessman Raymond F. Schoenke Jr., also has tapped into the issue by running television ads in Baltimore touting his support for giving members of HMOs more freedom to pick their physicians.

Outlining a health-care campaign agenda for her campaign against Glendening, Rehrmann, the two-term Harford County executive, also called for the creation of an advocacy office in the state health department to help patients cope with conflicts with their HMOs.

"As you talk to people across Maryland, hardly any of us don't know someone who's had an experience they shouldn't have had with their HMOs," Rehrmann said at a news conference yesterday.

Rehrmann held the event in Violetville at the home of Joan Rohrbaugh, who described a conflict six years ago with her HMO over the length of her hospital stay before brain surgery.

Rehrmann's proposal comes in the midst of a debate in Maryland and across the nation over reining in problems with HMOs and managed care organizations.

Congress is weighing legislation to further regulate HMOs, an issue that has won support from Republicans and Democrats.

The General Assembly defeated a bill this year to put medical directors of HMOs under the same disciplinary scrutiny as doctors. That bill would have licensed HMO directors, and possibly would have made them subject to malpractice claims.

The legislature enacted a compromise that enhanced a system in which HMO patients can appeal to the state insurance commissioner to overturn coverage decisions. The bill also put HMO medical directors under the oversight of the state insurance administration, but stopped short of making them potentially subject to such discipline as loss of licenses.

Gerard E. Evans, an Annapolis lobbyist for two HMOs, said the General Assembly has passed major legislation to cope with complaints about HMOs and called the appeals bill that passed this year the strongest in the nation.

During debate on the HMO bills, Glendening deferred to the legislature. Peter Hamm, a campaign spokesman, said the governor is staying neutral.

Schoenke supports legislation that would force HMOs to accept into their networks any physician willing to accept their fee structure, a spokesman said.

Dr. Terry McGuire, a physician who is making a run for the Democratic nomination, said he would make HMOs -- and not just affiliated physicians -- liable for malpractice for decisions they make.

Pub Date: 6/11/98

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