SENATE MEMORIAL 90

49th legislature - STATE OF NEW MEXICO - first session, 2009

INTRODUCED BY

John C. Ryan

A MEMORIAL

REQUESTING THE DEPARTMENT OF HEALTH TO MONITOR THE AMERICAN MEDICAL ASSOCIATION'S DEVELOPMENT OF A HEALTH INSURER CODE OF CONDUCT AND TO PROMOTE COMPLIANCE BY INSURERS WITH THE CODE WHEN IT IS PROMULGATED.

     WHEREAS, New Mexicans face numerous challenges pertaining to health insurance, whether they have full coverage, less than adequate coverage or no coverage at all; and

     WHEREAS, in uncertain economic times, affording health insurance is becoming more difficult for many businesses and citizens; and

     WHEREAS, providers of health care, particularly physicians and hospitals, are subjected to health plan intrusions into clinical decision-making that compromise clinical autonomy of physicians and are not in the best interest of the patient, resulting in significant increases in the cost of health care; and

     WHEREAS, these intrusions include diagnostic studies and limitations, therapeutic requirements that may involve questionable payments to physicians and others and restrictive formularies and prescribing practices; and

     WHEREAS, to help curtail skyrocketing health care costs, the health care industry must establish policies and practices to allow physicians and others to make decisions based on patient needs without creating roadblocks to appropriate treatment, to ease the denial and preauthorization process and to become more transparent; and

     WHEREAS, the American medical association unanimously adopted a resolution calling for a health insurer code of conduct that would address medical care policies and payment issues; and

     WHEREAS, the code of conduct will be a valuable tool for citizens and businesses to provide information that would affect decision-making with respect to choice of insurers; and

     WHEREAS, the voluntary code of conduct will also benefit patients, physicians and other health care providers by challenging health plans to modify their restrictive practices; and

     WHEREAS, monitoring compliance with the health insurer code of conduct may provide valuable data to inform the public and may also generate support for advocacy efforts; and

     WHEREAS, compliance data could provide consumers with an additional tool for comparing health plans during enrollment periods and could help consumers understand all the factors that go into the choices their physicians make when prescribing medicines; and

     WHEREAS, the availability of compliance data to consumers will motivate health plans to modify unacceptable practices;

     NOW, THEREFORE, BE IT RESOLVED BY THE SENATE OF THE STATE OF NEW MEXICO that the department of health be requested to monitor the development by the American medical association of the health insurer code of conduct and provide input if appropriate; and

      BE IT FURTHER RESOLVED that the secretary of health promote compliance by insurers with the health insurer code of conduct when it is promulgated; and

      BE IT FURTHER RESOLVED that a copy of this memorial be transmitted to the secretary of health.

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