S.B. 642

VETOES

(f) On or before October 15, 1996, the House Chairman of the Task Force
shall report the recommendations of the Task Force to the House Economic Matters
Committee and the Senate Chairman of the Task Force shall report the recommendations
of the Task Force to the Senate Finance Committee.

SECTION 3. AND BE IT FURTHER ENACTED, That Section 2 of this Act shall
take effect June 1, 1996.

SECTION 4. AND BE IT FURTHER ENACTED, That Section 1 of this Act shall
take effect October 1, 1996.

May 22, 1996

The Honorable Thomas V. Mike Miller, Jr.
President of the Senate
State House
Annapolis MD 21401

Dear Mr. President:

In accordance with Article II, Section 17 of the Maryland Constitution, I have today
vetoed Senate Bill 642.

The bill establishes an Advisory Committee on Health Maintenance Organization (HMO)
Performance. The Committee is composed of 13 members, including representatives from
the public, the health care industry, and relevant State agencies. The statutory purpose of
the Committee is twofold: to promote the dissemination to consumers of information
relating to HMO performance, and to receive and facilitate the investigation of
complaints of health care providers concerning the operation of any HMO in the State.

With respect to the duties of the Commission relating to information dissemination, I
agree with the supporters of the legislation that there should be a more centralized,
coordinated effort to ensure consumers in this State receive all the information available
on HMO performance. Currently, three different State agencies collect and keep
information on HMOs: the Department of Health and Mental Hygiene (DHMH), the
Health Care Access and Cost Commission (HCACC), and the Maryland Insurance
Administration (MIA). The agency whose duties are most similar to those charged to the
Committee is HCACC, which under law must conduct an annual evaluation of HMOs
based on performance and outcomes, and publish the data in an annual "HMO report
card." The law directing HCACC to publish a report card does not require the inclusion
of other information which DHMH and MIA collect, such as the financial condition of
the HMO, the degree to which the HMO provides benefits as compared to the amount of
premiums it collects, and information on complaints by patients against HMOs.
Consumers need and deserve a readily available and comprehensive source for all
relevant information on HMO performance.

Although the creation of an Advisory Committee represents one possible approach to
making the body of information relating to HMOs available and more "user friendly," one
of the major goals of this Administration has been and will continue to be to lessen the
size of State government, including the number of boards and commissions which
presently exist. Before Maryland takes the step of creating a new bureaucracy in addition

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