PARRIS N. GLENDENING, Governor                          H.B. 1370

Committee to facilitate the investigation of complaints, presumably meaning
investigations by MIA. This overlapping authority creates the potential for confusion and
inconsistent outcomes. I am mindful, however, that one of the driving forces behind this
aspect of the bill is the ongoing tension between HMOs and health care providers,
including minority providers, who can be aggrieved by adverse actions and decisions by
HMOs. Providers must have access to a meaningful grievance mechanism. This is
particularly true as more and more Marylanders opt to receive their health insurance
through HMOs. The passage of Senate Bill 750, which authorizes the enrollment of
Medicaid patients in "managed care organizations" which are not necessarily HMOs, also
highlights the general shift toward managed care.

On May 14, 1996, I signed the Health Care Payor and Provider Act of 1996, House Bill
1374. That bill, among other things, established a temporary Task Force to Study Patient
and Provider Appeal and Grievance Mechanisms. The Task Force is charged with
evaluating the effectiveness of patient and provider grievance mechanisms used to appeal
decisions of HMOs. The Task Force is to report any recommendations for changes by
October 15, 1996. Before creating a separate and permanent advisory committee to
consider complaints by providers, it would seem worthwhile to await the findings and
recommendations of the Task Force.

In summary, the purposes of this bill are laudable and I support them in concept. If
administrative efforts to improve the coordination of HMO activities prove less than
satisfactory, or the Task Force, under House Bill 1374, confirms the need for changes to
the recently enacted law relating to provider complaints, I will look forward to working
with the sponsors of this legislation on a bill for next year.

For these reasons, I have vetoed House Bill 1370.

Sincerely,

Parris N. Glendening

Governor

House Bill No. 1370

AN ACT concerning

Advisory Committee on Health Maintenance Organization Performance

FOR the purpose of establishing an Advisory Committee on Health Maintenance
Organization Performance; establishing the purposes of the Committee; specifying
the composition, terms of appointment, and staff services for the Committee; and
generally relating to the establishment of an Advisory Committee on Health
Maintenance Organization Performance.

BY adding to

Article - Health - General

Section 19-705.6

Annotated Code of Maryland

(1990 Replacement Volume and 1995 Supplement)

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