Gov. Kitzhaber signs `Patients Bill of Rights'

SALEM (AP) - A "Patient's Bill of Rights" signed into law Wednesday by Gov. John Kitzhaber would give 2 million Oregonians new tools to challenge health coverage decisions.

The governor said the measure is "an important step toward ensuring that certain people who have coverage can be confident that the system is truly responsive to their needs."

When HB3040 takes effect July 1, 2002, those covered by HMOs, preferred provider organizations and regular indemnity health insurers will gain the following rights:

· When facing a denial of coverage, consumers are entitled to appeal to an impartial expert reviewer certified by the state.

· Health plans that refuse to submit to external review become legally open to lawsuits, and plans that fail to follow an independent reviewer decision face fines starting at $100,000 per offense and also become open to lawsuits.

· When a doctor leaves a health plan's network, a patient is entitled to continue seeing that doctor, at the plan's expense, for as many as 120 days if the patient is amid active treatment.

· Health plans that require primary care physicians to order specialist care must offer standing referrals for ongoing visits and give policyholders a right to a second opinion on denied referrals.

· Health plans that exaggerate the number of doctors available to members face unfair-trade penalties.

The bill also directs the state Department of Consumer & Business Services to draft uniform measures for consumers to compare the size and adequacy of the doctor and hospital networks used by managed care plans.

The law does not apply to the hundreds of thousands of workers and their families covered by employer groups that are self-funded and exempt from state regulation.

Dozens of supporters of the legislation, including lobbyists and representatives of the insurance industry and the AFL-CIO labor federation, gathered in the governor's ceremonial office Wednesday to watch the signing.

John Powell, lobbyist representing Regence Blue Cross, said the bill was worked out by a working group in which the insurance companies cooperated with labor in order to head of a possible ballot measure.

Kitzhaber and others said the provisions in the bill might become a model for the United States.