By JESSICA TOLEDANO

Staff Reporter

Managed health care reform has become a top priority on Capitol Hill, but those federal "patients' bill of rights" proposals will have little impact on California because most of their provisions already exist under state law.

"California is the bellwether state for America, particularly in regards to the patients' bill of rights," said Assemblyman Martin Gallegos, D-Baldwin Park, who chairs the Assembly Healthcare Committee. "The state has had its own version of the patients' bill of rights for a long time. Many of the provisions being proposed in Congress have already been passed and signed into law in California."

One reason California may be ahead of the game is that 85 percent of insured residents in the state are enrolled in some form of managed care. California makes up 26 percent of the total managed care population in the country with more than 18 million people belonging to a health plan. So it is no surprise that state lawmakers began to focus on the issue early.

In addition, growing public angst over access to quality care has put significant pressure on lawmakers to craft legislation that would give consumers new protections.

"We have been responding to constituent complaints about health care for a long time," said Assemblyman Bob Hertzberg, D-Van Nuys. "California is now setting the trends for the nation. This is nothing new for us."

In fact, many provisions in both the Republican and Democratic versions of the patients' bill of rights duplicate existing laws or pending legislation in California.

For example, last year Assemblywoman Susan Davis, D-San Diego, introduced a bill that would allow women direct access to an obstetrician-gynecologist, without having to get prior approval from a primary care physician or HMO. The bill, AB 12, was signed into law last year. Direct access to an OB/GYN is part of the proposed patients' bill of rights as well.

Another example is AB 607, signed into law this year, requiring HMOs to provide more information on treatment plans. The same provision is laid out in the various federal reform proposals. Also AB 1181, signed into law this year, which guarantees chronically ill patients access to specialists care, is part of the federal proposals.

All together, the state Legislature has pushed through five bills that are part of a California patients' bill of rights. And there are numerous other bills pending in the Legislature that address health care reform. Almost all the state provisions are contained in the federal bills.

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