American Healthline
Four patients’ rights champions — Reps. Charles Norwood (R-Ga.), John Dingell (D-Mich.), Greg Ganske (R-Iowa) and Sen. Edward Kennedy (D-Mass.) — have proposed a new compromise bill, hoping to capture Senate Republican votes needed to pass managed care legislation this fall, the New York Times reports. The legislation, a revision of the House-passed Norwood-Dingell bill, would affect all private health insurance plans, protecting at least 160 million Americans, more than three times as many as the bill passed by the Senate earlier this year. To allay Republican concerns, the compromise would protect states’ rights to regulate health insurance and allow patients to file suit against HMOs in state court only if a health plan denied a claim because “a service was not medically necessary … or experimental.” Patients would have to sue in federal court to challenge an HMO’s administrative decisions to deny benefits, which are not related to medical judgments. In addition, the compromise would shield employers from lawsuits unless they “directly participated in a decision to deny benefits” that led to the injury or death of a patient and would not allow plaintiffs in such cases to sue for punitive damages unless employers showed “willful or wanton disregard for the rights or safety” of patients. According to American Medical Association Chair Dr. D. Ted Lewers, the medical group “strongly supports” the revised patients’ rights measure. “It covers all Americans and holds health plans accountable for actions that harm patients,” he said. Norwood spokesperson John Stone said that the Georgia congressman offered the compromise to House Speaker Dennis Hastert (R-Ill.) and “a number of Republicans” in the Senate. “We want to hold together the coalition we have in favor of the Norwood-Dingell bill, while doing what we can to bring in some reluctant Senate supporters,” he added (Pear, 9/13).
Surrender, or Else!
Meanwhile, the California-based Foundation for Taxpayer and Consumer Rights urged Rep. Anne Northup (R-Ky.), who voted against Norwood-Dingell, to change her vote on the legislation or to sign a waiver rescinding her right to sue HMOs as a federal employee, the Owensboro Messenger-Inquirer reports. Jamie Court, executive director of the group, sent the waiver to Northup yesterday, targeting the lawmaker because she has accepted contributions from HMO giant Humana Inc. Northup said that she will not sign the waiver and refuses to back Norwood-Dingell. “I think the question is not whether you have the right [to sue HMOs], the question is do we want that to be the only recourse so that we push the cost of health insurance so high,” she said, noting that she supports the right to sue HMOs “only as a last resort.” Court also plans to send appeals to Rep. Rick Lazio (R-N.Y.) and all others who voted against the House measure, as well as Sens. Spencer Abraham (R-Mich.), John Ashcroft (R-Mo.) and Christopher Bond (R-Mo.) (Chambers, 9/13).
