"I think the final product will look much like it does today," he said.
The legislation would require health care insurers and health maintenance organizations to establish internal grievance procedures for members and would authorize the Maryland Insurance Administration to investigate complaints if a carrier refuses to pay for treatment.
The state agency could then make decisions on a question of medical necessity after consulting health care professionals.
Donoghue proposed the legislation in a response to complaints from people who were denied coverage for bone-marrow transplants, cancer treatments and other medical procedures.
"We were able to craft something that we think addresses a large majority of the complaints," he said.
The House approval is a major step for Donoghue, who began investigating the issue of patient grievances two years ago when he chaired a health care task force. That was followed by his first attempt to get grievance and appeals legislation passed last year - an effort that failed on the final night of the 1997 session.
This year's legislation is similar, but deals with more issues, he said. The Maryland Association of HMOs did not oppose the legislation
"I think we built on last year's bill and it's a better bill," Donoghue said.