SEARCH SITE

VIRGINIA LAW PORTAL

SEARCHABLE DATABASES

ACROSS SESSIONS

Developed and maintained by the Division of Legislative Automated Systems.

1998 SESSION


SENATE JOINT RESOLUTION NO. 99
Directing the Joint Commission on Health Care to study the need for an ombudsman program and an external appeals mechanism for insurance issues.

Agreed to by the Senate, February 13, 1998
Agreed to by the House of Delegates, March 12, 1998

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.