41.   But studies have indicated that an average tied to fee-for-service payments has grossly overpaid managed care plans which historically have enrolled younger, healthier beneficiaries.

42.   But the Internet sites may not be able to tap into all of that market because many managed care plans have exclusive relationships with mail-order pharmacies.

43.   But the loss of Oxford could present a major setback for the state as it begins to require Medicaid patients to enroll in managed care plans.

44.   But smaller managed care plans are in danger as they scramble to merge and come up with financing for new information systems.

45.   But the new regulations in New Jersey apply only to health maintenance organizations, and not all managed care plans.

46.   But today, managed care plans may withhold approval for expensive procedures or hospital admissions, so patients do not receive care recommended by their doctors.

47.   But there are significant differences between the parties over how aggressively the federal government should regulate a health care industry increasingly dominated by managed care plans.

48.   But when they select a managed care plan, what they may need the most is a crash course in assertiveness, Rybka said.

49.   Certainly not the U.S. Congress, which ultimately will be responsible for deciding what sort of health-care reform plan -- if any -- will be adopted.

50.   Committee members Thursday added numerous amendments to regulate managed care plans and to protect consumers.