PRINTER'S NO. 2268
No. 1856 Session of 1995
INTRODUCED BY VEON, DeWEESE, BELARDI, CORRIGAN, ROONEY, KING,
JOSEPHS, MANDERINO, TRELLO, ITKIN, STABACK, OLASZ,
YOUNGBLOOD, MELIO AND LAUGHLIN, JUNE 21, 1995
REFERRED TO COMMITTEE ON HEALTH AND HUMAN SERVICES,
JUNE 21, 1995
AN ACT
1 Amending the act of July 8, 1986 (P.L.408, No.89), entitled, as
2 reenacted and amended, "An act providing for the creation of
3 the Health Care Cost Containment Council, for its powers and
4 duties, for health care cost containment through the
5 collection and dissemination of data, for public
6 accountability of health care costs and for health care for
7 the indigent; and making an appropriation," further providing
8 for a reporting system.
9 The General Assembly of the Commonwealth of Pennsylvania
10 hereby enacts as follows:
11 Section 1. Section 5(d) of the act of July 8, 1986 (P.L.408,
12 No.89), known as the Health Care Cost Containment Act, reenacted
13 and amended June 28, 1993 (P.L.146, No.34), is amended by adding
14 a paragraph to read:
15 Section 5. Powers and duties of the council.
16 * * *
17 (d) General duties and functions.--The council is hereby
18 authorized to and shall perform the following duties and
19 functions:
20 * * *
1 (14) Develop an independent system, including
2 standardized reporting procedures, to collect statistics to
3 allow comparisons between health maintenance organizations on
4 the delivery of health care services and health outcomes of
5 members; issue and publish annual standard health maintenance
6 organization report cards which allow consumers to make
7 comparisons between health maintenance organizations based on
8 health outcomes and on how various health care needs are
9 addressed by each health maintenance organization. These
10 reports shall include information on the percentage of total
11 members and the percentage of members seeking treatment per
12 1,000 members. In developing this system, the council shall
13 review similar efforts in other states or within the managed
14 care industry. Each health maintenance organization shall
15 annually provide their members with a current copy of their
16 annual standard report card, and shall include a copy of
17 their most recent annual report card in promotional and
18 enrollment information. As used in this section, the term
19 "health outcomes" means the results of treatment adjusted for
20 severity for patients seeking treatment, the recurrence of
21 treatment and treatment received which is indicative of the
22 possible lack of treatment of a less severe but related
23 health problem.
24 Section 2. This act shall take effect in 60 days.
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