State regulation of private health insurance: prescription drug benefits, experimental treatments, and consumer protection.
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.
Bolin
Jane Nelson
JN
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.
Buchanan
Robert J
RJ
Smith
Scott R
SR
D003254:Consumer Advocacy / Q000331:legislation & jurisprudence*; D004608:Eligibility Determination / Q000331:legislation & jurisprudence; D018588:Fee-for-Service Plans / Q000331:legislation & jurisprudence*; D006801:Humans; D019458:Insurance Coverage / Q000331:legislation & jurisprudence*; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D007356:Insurance, Pharmaceutical Services / Q000331:legislation & jurisprudence; D008329:Managed Care Programs / Q000331:legislation & jurisprudence*; D013219:State Government; D011795:Surveys and Questionnaires; D014481:United States