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1998 SESSION
WHEREAS, the Virginia Department of Health (VDH) conducted a 1997 study, pursuant to House Bill No. 2785, of the Role of the Commonwealth in Monitoring and Improving the Quality of Care in Managed Care Plans; and
WHEREAS, the VDH study made a number of recommendations for improving oversight of managed care plans; and
WHEREAS, the VDH study did not recommend pursuing either an ombudsman program or an external appeals mechanism; and
WHEREAS, the long-term care ombudsman program has been a successful model for mediating disputes; and
WHEREAS, certain other states have implemented an external appeals mechanism; and
WHEREAS, a consensus does not yet exist regarding the appropriateness of an external appeals mechanism or an ombudsman program for insurance issues; now, therefore, be it
RESOLVED by the Senate, the House of Delegates concurring, That the Joint Commission on Health Care be directed to study (i) the costs and benefits of an ombudsman program for health insurance issues and (ii) the costs and benefits of requiring an external appeals mechanism for managed care health insurance plans.
All agencies of the Commonwealth shall provide assistance to the Joint Commission for this study, upon request.
The Joint Commission shall complete its work in time to submit its findings and recommendations to the Governor and the 1999 Session of the General Assembly as provided in the procedures of the Division of Legislative Automated Systems for the processing of legislative documents.