Washington Post

A consumer rights foundation has asked the Senate ethics committee to investigate whether Majority Leader Bill Frist (R-Tenn.) improperly promoted legislation to limit medical malpractice awards while maintaining what it called “personal and financial ties” to a large hospital chain with a malpractice insurance subsidiary.

The complaint was filed late Monday by the Foundation for Taxpayer & Consumer Rights of Santa Monica, Calif., which has a long history of opposing curbs on malpractice litigation. It was promptly circulated around Washington by the Democratic Senatorial Campaign Committee, which also questioned what it described as a potential conflict of interest on Frist’s part.

The ethics committee declined to comment on the complaint. Frist spokeswoman Amy Call described the complaint as a “political exercise.” She said the Senate leader has received “numerous rulings from the ethics committee” noting that its rules did not bar him from working on health issues because of his personal and family finances.

At the center of the controversy is the Hospital Corporation of America (HCA), the nation’s largest for-profit hospital company, which has been run primarily by Frist’s father, Thomas Frist, and brother, Thomas Frist Jr.

The senator, who was a heart transplant surgeon before he was elected to the Senate in 1995, was never employed by the company or any of its hospitals, but his HCA stock holdings constituted a major share of his considerable wealth. Frist valued his HCA holdings at more than $13 million when he first ran for the Senate. After the election, he put them in a blind trust, out of his control. Recent financial disclosure statements value the blind trusts for Frist and his family at many millions of dollars.

In the Senate, Frist has championed a series of health care-related causes, including Medicare legislation last year and, more recently, a bill backed by most Republicans that would cap damage awards in medical malpractice suits against doctors, hospitals and makers of medical devices. Bills to limit all such damages and a narrower measure to limit them for obstetricians and gynecologists were blocked by Democratic-led filibusters. The Senate will vote today on another targeted measure to limit damages involving suits against both OB-GYNs and emergency room personnel. Democrats say they have the votes to prevail on that bill, too.

In its letter to the ethics panel, the consumer rights foundation noted that Health Care Indemnity, which it described as a wholly owned subsidiary of HCA, is the nation’s sixth-largest medical malpractice insurance company, with $260 million in premiums annually.

“We believe this conflict should disqualify Senator Frist from involvement in any legislation concerning liability limits benefiting hospitals and malpractice insurers, and can no longer be overlooked,” Carmen Balber, the foundation’s consumer advocate, said in the letter.

Recent contributions of HCA stock to family trusts underscore the importance of the company to the family’s fortune, which cannot be disguised by the “blind” nature of the trusts, she added.

While acknowledging the previous ethics committee rulings in Frist’s favor, Balber said the senator’s “current involvement in the medical malpractice debate rises beyond the level of general concern for health issues to specific advocacy for his family’s company.”

In two earlier letters, released by Frist’s office, the ethics panel noted that Frist’s family does not own anything approaching a controlling interest in HCA and found no reason to bar Frist from involvement with health care issues in the Senate. But it also warned that “appearances of a conflict of interest” need to be evaluated in dealing with specific bills.

Frist was motivated to get involved in the malpractice debate because, “as a doctor, he has seen firsthand the damage that soaring malpractice rates can have on patients and patient care,” according to Call, his spokeswoman. “Anybody who knows Bill Frist knows he is first and foremost an ethical person, and he is motivated by creating good policy and providing good patient care,” she added.