United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1999-03-11 monographic deposited born digital 32 p. GA 1.13:T-HEHS-99-85 https://www.govinfo.gov/app/details/GAOREPORTS-T-HEHS-99-85 P0b002ee18038e171 f:he99085t DGPO 2010-08-12 2011-03-28 GAOREPORTS-T-HEHS-99-85 machine generated eng fdlp REPORT GAOREPORTS-T-HEHS-99-85 T-HEHS-99-85 Health maintenance organizations Patient care services State law Physicians Consumer protection Health services administration Proposed legislation Health insurance California Colorado Connecticut Florida Kentucky Maryland Massachusetts Minnesota New Jersey New York Ohio Oregon Pennsylvania Texas Vermont Testimony HEHS E99085 Pursuant to a congressional request, GAO discussed selected state patient protection provisions already in place and congressional proposals under consideration, focusing on state statutes that relate to seven types of patient protections: (1) coverage of emergency services; (2) access to obstetricians and gynecologists; (3) access to pediatricians; (4) access to other specialists; (5) continuity of care for enrollees whose providers leave the plan; (6) drug formularies; and (7) patient-provider communication.<p/>GAO noted that: (1) many states have responded to managed care consumers' concerns about access to health care and information disclosure; (2) however, they often differ in their specific approaches, in scope and in form; (3) two states--California and Minnesota--have laws or regulations that address all seven types of protections GAO analyzed; (4) two other states--Colorado and Massachusetts--have laws that address three or fewer protections; (5) the patient protection most common among the 15 states addresses open patient-provider communication; (6) provisions addressing coverage of emergency health care and access to certain specialists were also prevalent among states; (7) in contrast, only four states had specific provisions to guarantee direct access to pediatricians; (8) although several states have continuity-of-care provisions, they can differ markedly in the criteria for coverage and time period allowed for transition; (9) about half of the states specify pregnancy as a condition subject to continuity-of-care coverage; (10) most of these states allow women in their second trimester of pregnancy to qualify for continuity-of-care protection if their physician leaves the plan; and (11) one state requires that women be in their third trimester to receive such coverage. https://www.govinfo.gov/content/pkg/GAOREPORTS-T-HEHS-99-85/html/GAOREPORTS-T-HEHS-99-85.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-T-HEHS-99-85/pdf/GAOREPORTS-T-HEHS-99-85.pdf GAO/T-HEHS-99-85 https://www.govinfo.gov/app/details/GAOREPORTS-T-HEHS-99-85 Testimony GAO/T-HEHS-99-85; Managed Care: State Approaches on Selected Patient Protections; Health maintenance organizations Patient care services State law Physicians Consumer protection Health services administration Proposed legislation Health insurance California Colorado Connecticut Florida Kentucky Maryland Massachusetts Minnesota New Jersey New York Ohio Oregon Pennsylvania Texas Vermont