[Congressional Record (Bound Edition), Volume 145 (1999), Part 9]
[Senate]
[Page 13040]
[From the U.S. Government Publishing Office, www.gpo.gov]



                        PETITIONS AND MEMORIALS

  The following petitions and memorials were laid before the Senate and 
were referred and ordered to lie on the table as indicated:

       POM-187. A joint resolution adopted by the Legislature of 
     the State of Nevada relative to the Employee Retirement 
     Income Security Act of 1974; to the Committee on Health, 
     Education, Labor, and Pensions.

                    Assembly Joint Resolution No. 15

       Whereas, On May 19, 1998, testimony was presented to 
     members of the United States Senate Committee on Labor and 
     Human Resources by the Honorable Marilyn R. Goldwater, Deputy 
     Majority Whip in the Maryland House of Delegates, urging 
     members of Congress to strengthen requirements for the 
     appeals processes for plans covered by the Employee 
     Retirement Income Security Act of 1974 (ERISA); and
       Whereas, In her presentation, Ms. Goldwater noted that it 
     is important to have strong, effective and responsive 
     internal grievance and appeal mechanisms in place; and
       Whereas, Every state requires managed care entities to have 
     an internal appeals process in place; and
       Whereas, If it is determined that a federal external 
     appeals process is appropriate, it should be administered by 
     the Federal Government according to rules established by 
     federal law, with states managing those plans under their 
     regulatory authority; and
       Whereas, Several states have enacted legislation to revise 
     and refine both the internal and external appeals processes; 
     and
       Whereas, In Maryland, legislation was enacted to strengthen 
     the state's internal grievance and appeals processes, 
     establish an external appeal mechanism and provide additional 
     regulatory authority to the state's insurance commissioner 
     over medical directors in health maintenance organizations; 
     and
       Whereas, In Florida, the nation's first external review 
     process was created in 1985, and Florida continues to fine 
     tune its process by utilizing a panel of six state employees 
     for the external review process, with explicit time frames 
     from ``extreme emergency'' cases to ``nonurgent'' cases; and
       Whereas, New Jersey enacted legislation in 1997 that 
     requires health maintenance organizations to establish an 
     external appeal process and now operates a consumer hot line 
     for consumer questions and complaints; and
       Whereas, Texas enacted landmark legislation in 1998 that 
     permits managed care enrollees to sue their health plans for 
     malpractice in cases where they have been harmed by a plan's 
     decision to delay or deny treatment; and
       Whereas, According to ``The Best From the States II: The 
     Text of Key State HMO Consumer Protection Provisions'' by 
     Families USA Foundation (October 1998), key consumer 
     protection provisions include the establishment of explicit 
     time frames for appeal of decisions, implementation of 
     methods for expediting the review of emergency and urgent 
     care situations, acceptance of oral appeals and adoption of 
     laws that require reviewers to be health care providers with 
     expertise in the clinical area being reviewed and that 
     prohibits reviewers from participating in the review of cases 
     in which they were involved in the original decisions; and
       Whereas, On February 9, 1999, in a letter to the editor of 
     the Las Vegas Sun, Marie Soldo, immediate past Chairman of 
     the Nevada Association of Health Plans, wrote that, because 
     the state has limited jurisdiction regarding the regulation 
     of health insurance plans, more than two-thirds of Nevadans, 
     including state and federal employees, Medicare and Medicaid 
     enrollees and others whose employers are self-insured, are 
     not affected by state legislative action such as mandated 
     benefits, improved grievance and appeals processes and the 
     proposed ombudsman office; now, therefore, be it
       Resolved by the Assembly and Senate of the State of Nevada, 
     Jointly, That the Nevada Legislature hereby urges Congress to 
     take steps to ensure that those plans which are exempt from 
     state regulation provide adequate protection provisions for 
     persons covered by such health plans; and be it further
       Resolved, That the Chief Clerk of the Assembly prepare and 
     transmit a copy of this resolution to the Vice President of 
     the United States as the presiding officer of the Senate, the 
     Speaker of the House of Representatives and each member of 
     the Nevada Congressional Delegation; and be it further
       Resolved, That this resolution becomes effective upon 
     passage and approval.
                                  ____

       POM-188. A petition from a citizen of the State of Florida 
     relative to tobacco; to the Committee on Health, Education, 
     Labor, and Pensions.
       POM-189. A petition from a citizen of the State of Florida 
     relative to federal income tax laws; to the Committee on 
     Finance.
       POM-190. A petition from a citizen of the State of Florida 
     relative to Social Security and Medicare laws; to the 
     Committee on Finance.
       POM-191. A petition from a citizen of the State of Florida 
     relative to water sources; to the Committee on Environment 
     and Public Works.
       POM-192. A petition from a citizen of the State of Florida 
     relative to court reform; to the Committee on the Judiciary.
       POM-193. A petition from a citizen of the State of Florida 
     relative to campaign financing reform; to the Committee on 
     Rules and Administration.
       POM-194. A petition from a citizen of the State of Florida 
     relative to paper money; to the Committee on Banking, 
     Housing, and Urban Affairs.
       POM-195. A resolution adopted by the Board of Directors, 
     Puerto Rico Bar Association relative to navy war practices at 
     the island of Vieques; to the Committee on Armed Services.
       POM-196. A petition from a citizen of the State of Indiana 
     relative to highway safety and the trucking industry; to the 
     Committee on Commerce, Science, and Transportation.

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