The District's chief insurance regulator yesterday blasted efforts by Maryland lawmakers to restructure CareFirst BlueCross BlueShield, saying that Maryland politicians are trying to take over the region's largest health insurer.
"Please be aware that we consider this attempt to be a direct and unwarranted attack on the District's health insurance system," insurance commissioner Lawrence H. Mirel said in a two-page letter sent to key lawmakers.
The Maryland General Assembly began considering legislation to reorganize CareFirst after Maryland Insurance Commissioner Steven B. Larsen rejected a proposal to sell the nonprofit insurer to a for-profit California-based firm. Larsen found that CareFirst's board shirked its fiduciary responsibilities by agreeing to a deal that undervalued the company and would have put $ 119 million in the pockets of few key executives.
CareFirst has 3.2 million subscribers in Maryland, the District, Virginia and Delaware. Maryland has 12 seats on the 21-member board, the District has six seats and Delaware has three.
Bills in the House and the Senate would remove all 21 board members by 2006. The bills do not specify who would appoint new board members from the District and Delaware. The Senate has passed its version of a reform plan. A hearing is expected today on the House plan, which would give the governor, the Senate president and the House speaker authority to appoint a nominating commission that would then choose the successors to the current board members.
Del. John A. Hurson (D-Montgomery) said he plans to meet with Mirel today to discuss his concerns.
Some activists who have been critical of CareFirst were outraged by Mirel's letter. In it, Mirel states that D.C. CareFirst subscribers are served by a "well-run, financially sound plan."
"For him to assert that the District plan is well run in light of Larsen's recent findings is eye-popping," said A.G. Newmyer III, who chairs the Fair Care Foundation in the District. "His [Mirel's] style of regulating is eyes wide shut."
Lawmakers hoping to crack down on bad doctors have reached a deal with the state's medical lobby, watering down key provisions in a bill that would change the way doctors in Maryland are disciplined.
Sen. Paula C. Hollinger (D-Baltimore County) and Del. John A. Hurson (D-Montgomery), who chair committees that deal with medical issues, said they believe that even with the compromise, more bad doctors will be punished. In recent weeks, both have come under heavy pressure from the Maryland State Medical Society.
At issue is the standard of proof that the Board of Physician Quality Assurance uses when it brings a case against a doctor. Currently, the case must be proven by "clear and convincing evidence," a standard far higher than most states use. With studies showing Maryland near the bottom of states when it comes to disciplining doctors, Hollinger and Hurson hoped to lower the standard to "preponderance of the evidence."
The Maryland State Medical Society fought such a move, and a compromise was forged. The state board that regulates doctors will use the preponderance-of-evidence standard in all but one type of disciplinary case: Those that deal with the standard of care a patient received. Such cases, which will still need to be proved by clear and convincing evidence, are among the most serious and can lead to malpractice suits.
The bill also would take the Maryland State Medical Society out of the business of appointing the doctors who sit on the Board of Physician Quality Assurance, a move Hollinger said she believes will lead to more disciplinary cases. The compromise is expected to pass the Senate and the House in the final days of this year's session. |
