Sacramento– The California Senate Appropriations Committee today passed, by a vote of 7-6, landmark legislation that would allow all patients the right to sue their HMO for an unreasonable denial of medically necessary treatment. The bill, SB 21 (Figueroa), is sponsored by the Foundation for Taxpayer and Consumer Rights (FTCR).

Last year the same bill failed in this committee. The vote signals a change in the attitudes of legislators who, as public employees have the right to receive damages against an HMO that injures them. Fourteen million Californians with health coverage through private industry do not have that right until SB 21 is enacted. The bill is modeled on a successful 1997 Texas Law which has resulted in only one lawsuit, but doctors report that treatment requests are dealt with more fairly since the law has been in effect.

“It is no wonder HMO abuses have become epidemic,” said Jamie Court, director of FTCR’s Consumers For Quality Care. “All working Californians should have the same right to sue their HMOs for damages as their public officials now have. Without the threat of damages, patients will continue to have no leverage against billion dollar HMOs that deny and delay medically necessary care.”

Last year, Consumers For Quality Care faxed a different story and picture of another “ERISA Casualty of the Day” — a patient denied treatment by an HMO or insurer and without a remedy–to legislators and the media for five months. This year, the consumer group is tracking HMO liability legislation in 23 states.

Supporting the measure were Senators Alpert (D), Bowen (D), Burton (D), Escutia (D), Karnette (D), Perata (D) and Vasconcellos (D). It was opposed by one Democrat, Senator Johnston and all five Republican Senators on the committee: Leslie, Johnson, Kelley, McPherson and Mountjoy. SB 21 now moves to a vote of the full Senate next week.

Consumers For Quality Care is a health care watchdog project of the non-partisan, non-profit Foundation For Taxpayer and Consumer Rights.

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