|Issuer:||William F. Weld|
|Mass Register:||No. 815|
Table of Contents
WHEREAS, managed health care insurance is rapidly growing in Massachusetts, insuring seventy-five percent of all workers, fifteen percent of all Medicare recipients, and all Medicaid recipients eligible for managed care, and
WHEREAS, according to national studies, the Commonwealth of Massachusetts is home to several of the highest rated managed care organizations in the country; and
WHEREAS, managed health care has successfully made the cost of insurance affordable and stemmed skyrocketing costs; and
WHEREAS, a systemic and comprehensive review of managed health care industry practices, consumer statistics, and existing and potential regulatory authority in Massachusetts ought to be conducted; and
WHEREAS, all consumers of managed health insurance should have access to appropriate care and treatment when medically necessary;
NOW, THEREFORE, I, William F. Weld, Governor of the Commonwealth of Massachusetts, by virtue of the authority vested in me as Supreme Executive Magistrate, do hereby order as follows:
Section 1. A Special Advisory Commission on Managed Health Care ("Advisory Commission") is hereby established. The Advisory Commission shall be composed of no more than fifteen (15) members appointed by the Governor, including: the Secretary of Administration and Finance; the Commissioner of Insurance; the Commissioner of Public Health; the Commissioner of Medical Assistance; the Director of the Board of Registration in Medicine; the Commissioner of Health Care Finance and Policy; the Commissioner of Mental Health; a licensed primary care physician; a representative from the American College of Surgeons; a consumer; a representative from the small employer/self- employed community; a representative from the employer community; a representative from the Massachusetts Association of Health Maintenance Organizations; a representative from the Massachusetts Medical Society; and a representative from the Massachusetts Hospital Association.
Section 2. The Advisory Commission shall make recommendations to the Governor on all aspects of managed health care in the Commonwealth. Any vacancies shall be filled by the Governor. The Governor shall select one of the appointed members as chairperson. Members shall serve without compensation, but shall be eligible for reimbursement of reasonable and necessary expenses incurred in the performance of their duties.
Section 3. In carrying out its responsibilities, the Advisory Commission shall:
(a) conduct a review of the current state of managed care practices in Massachusetts, including but not limited to enrollment, emergency admissions standards, utilization review, grievance procedures, and quality assurance;
(b) recommend whether and what regulations or legislation, if any, should be promulgated or introduced to ensure that consumers continue to benefit from high quality health care at affordable costs;
(c) determine whether the Commonwealth should collect and make available to the public quality of care standards of managed health care insurers; and
(d) report its findings and recommendations to the Governor within six (6) months and make the report available to the public and the Legislature.
Given at the Executive Chamber in Boston this 7th day of April in the year one thousand nine hundred and ninety-seven.
William F. Weld
William Francis Galvin
Secretary of State