North Carolina Gov. Mike Easley and a squad of legislators from both parties recently rolled out a patients bill of rights-a package of managed care reform bills designed to tear down the impediments to medical treatment that consumers and doctors encounter from insurance companies. Among other steps, the legislation would create a state-supervised review board to hear appeals from patients whose HMO didn't pay for treatment. It would also give patients greater power to sue their HMO after first appealing to the review board, as well as create an ombudsman office in the State Department of Insurance to help consumers confront their HMO. Under the proposed legislation, managed care plans would be required to continue to cover pregnancies and surgery, for example, even if the doctor leaves the insurance plan in the course of treatment. It's not clear how the legislation would affect managed care plans other than HMOs.

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