Failing to take decisive action on a politically charged issue, a task force in California has recommended two alternatives for creating a new state agency to oversee managed-care plans operating in the state.
The alternatives will be included in a report the task force is scheduled to present to Gov. Pete Wilson next month. Wilson and lawmakers are expected to use the report to formulate major legislation on how managed-care plans should operate and be regulated in the state.
Over the past year, Wilson has vetoed or refused to take action on dozens of managed care-related bills until he heard from the task force. He said he wanted to avoid uncoordinated, reactive, piecemeal decisionmaking in managed-care oversight.
The task force was created by a bill signed into law last year. The law charged the group with, among other things, reporting on whether managed-care plans are controlling costs and improving quality and access to care. Wilson also asked the group to make recommendations on the state's regulation of managed care. It has met about every three weeks since April.
The 30-member task force, meeting in Sacramento Dec. 13, voted to recommend two alternatives for a new oversight agency. The first would create a board with five members, two of whom would be chosen by the Legislature and three by the governor. It would be headed by "an individual of stature" in healthcare appointed by the governor and confirmed by the Legislature. That structure would be unique among state agencies that regulate managed care.
The second alternative is to create a new agency headed by a single appointed individual with stature in healthcare.
The task force did not specify to whom the new agency or board would report. But whoever becomes the state's new managed-care czar likely would have a great deal of flexibility, money and resources at his or her disposal. "I imagine people are drooling over the job," said an observer who didn't want to be identified.
The new regulatory body would re place the state Department of Corporations as the chief overseer of HMOs in California. The task force recommended that the new agency study whether it should also take over regulation of indemnity plans from the Department of Insurance.