Wilson Signs Bills Reforming HMO Surgery Policies

Gov. Pete Wilson signed bills Thursday that will force HMOs to cover the costs of reconstructive surgery to fix birth defects and allow women to stay in the hospital after breast surgery.

In addition, the governor signed several other measures, including bills dealing with education, the state lottery and prepaid phone cards.

The bill dealing with so-called “drive-through mastectomies” requires a doctor and patient to determine how long a woman should stay in the hospital after a mastectomy. The other requires plans to cover reconstructive surgery to fix birth defects.

The health care bills are among the few survivors of a two-year political battle between the Legislature and Wilson over the managed care plans that provide health insurance for about 17 million Californians.

The Republican governor two weeks ago vetoed a half-dozen bills aimed at regulating HMOs. Those included bills that would have required coverage for contraceptives and vaccines for children.

Wilson and many business groups say specific coverage requirements will drive up the cost of health coverage.

Assemblywoman Liz Figueroa (D-Fremont) introduced a mastectomy bill after hearing about a Newark woman whose surgery began at 11:30 a.m. and was sent home by 4:30 p.m. Figueroa and Assemblywoman Valerie Brown (D-Kenwood) are the authors of the new law, which takes effect July 1.

Figueroa’s reconstructive surgery bill, which takes effect Jan. 1, was introduced because many plans only cover surgery that is medically necessary to restore a body function.

During hearings, Figueroa distributed photographs of a 7-year-old girl named Amy, who was born without an ear. Her HMO denied surgery to give her a new ear because it was not needed for her to hear.

The governor also signed health care bills that:

* Require health plans to cover general anesthesia for dental work for patients under 7 years old, those who are developmentally disabled and those for whom anesthesia is medically necessary.

* Remove some of the paperwork to get painkilling narcotics for terminally ill patients.

Wilson also signed a variety of other bills.

One will require phone companies to tell customers exactly what they are getting when they buy prepaid phone cards.

“This will prevent phone companies from promoting 10-cent-a-minute rates and then turning around and slapping people with a $2 surcharge to connect each and every call they make with the card,” said the bill’s author, Assemblywoman Debra Bowen (D-Marina del Rey.)

The bill, effective Jan. 1, requires firms to disclose all fees or surcharges in advertisements and to have a toll-free number with a live operator to provide information and hear complaints.

Wilson also signed a measure that will allow voters in 2000 to decide whether half of future increases in state lottery revenues should be spent on buying textbooks and instructional materials for public schools and community colleges.

The bill’s author is Assemblyman Tony Cardenas (D-Sylmar).

The governor also signed a bill to create the California State Summer School for Mathematics and Science. It will last four to six weeks. The State Board of Education will appoint a director and committee to help run the program.

The bill by Assemblyman Charles Poochigian (R-Fresno) will create the summer school for high school students who are doing well in science and math.

And on another education measure, Wilson signed a bill by Assemblywoman Carole Migden (D-San Francisco) that allocates $5 million to try to increase college preparation for students in schools that don’t send many children to college.

The bill lets regional partnerships of local school districts, colleges, community organizations and businesses apply for grants. They would then tutor high school students after school or prepare them to take college entrance exams.