House Approves Patients' Rights Legislation 

Sent: Wednesday, August 08, 2001 

House Approves Patients' Rights Legislation 

The House of Representatives, on August 3, 2001, approved a modified  version  of a bipartisan patients' bill of rights that would create new federal  rights for millions of Americans enrolled in managed care plans, after  revising the legislation to limit lawsuits against insurance companies. 

In approving the bill by a vote of 226 to 203, the Republican-controlled  House handed an important political victory to President Bush, who had  complained that a bill sponsored by Reps. Charles Norwood (R-GA), Greg  Ganske (R-IA) and John Dingell (D-MI) would result in increased  litigation,  leading to health insurance premiums and to an increase in the number of  uninsured Americans. 

The legislation would guarantee patients a variety of services on which  the  political parties largely agree. Under the bill, health insurance plans  must  provide patients prompt access to medical specialists, must allow women  to  visit obstetricians and gynecologists without a referral and must permit  patients to obtain emergency care at the nearest hospital, even if it  is not  affiliated with a specific health plan. The bill, as passed by the  House,  includes a provision long advocated by AMHCA, which would prevent health  plans from discriminating against providers based on their license. 

Also approved, by a vote of 236 to 194, was an amendment to expand  access to  tax-preferred medical savings accounts. Members also defeated an  amendment  to reform the nation's medical malpractice laws, including a $250,000  cap on  damages for pain and suffering.  The bill's health plan liability sections, approved by a vote of  218-213,  reflect a deal made by the White House and Rep. Norwood (R-GA), a  conservative who has led the fight for patients' rights legislation for  more  than six years. Norwood, a dentist, abandoned his original bill and its  sponsors and agreed to changes sought by the Administration in exchange  for  the President's promise to sign the legislation. 

Under the last minute deal cut by Norwood and Bush, patients who believe  they have been denied necessary medical coverage would have the right to  appeal the decision to an independent review panel and would be  guaranteed a  timely answer. Patients who reject the review panel's decision could  take  the dispute to court, but they would face a number of constraints,  including  a higher burden of proof. Juries would be instructed to presume the  patient  is wrong unless the patient proves otherwise. Such lawsuits could be  brought  in state court but they would be subject to federal judicial rules that  are  more restrictive. Dingell-Ganske preferred allowing patients to sue in  state  court under state rules, which are more receptive to their claims and  frequently provide generous damage awards. 

Also as part of the compromise with the White House, patients denied  treatment would be allowed to sue for punitive damages, but only when  an HMO  had refused to abide by the ruling of an independent review board.  Unlike  the original bill, and the bill that passed the Senate, the deal  includes  caps of $1.5 million on non-economic "pain and suffering" damages, and a  similar cap on punitive damages. The Senate-passed bill includes no cap  on  non-economic recoveries and a $5 million cap on punitive damages. The  measure would also restrict future class-action lawsuits against health  plans, although it would allow cases that are currently pending to  continue. 

For six years, Congress has struggled over how to protect patients from  health maintenance organizations and health insurers that deny them  medical  treatment. Despite passage of a patients' bill of rights in the House,  the  struggle will likely continue. In the Senate, supporters of broader  patients' rights legislation have vowed to reverse Bush's changes  during a House-Senate conference to resolve differences in the bills passed by  each chamber. When House and Senate negotiators are named for the conference committee, grassroots action by AMHCA members and others interested in  this issue will be essential for ultimate victory 

Beth Powell 

AMHCA Director of Public Policy and Professional Issues 

Opinions expressed in this web site do not necessarily reflect the views of NAMI Santa Cruz County, NAMI California or any affiliated organizations.  We attempt to present a balanced perspective on issues by presenting multiple viewpoints.

Copyright 2005 National Alliance for the Mentally Ill Santa Cruz County, All Rights Reserved.

FAIR USE NOTICE: This may contain copyrighted (©) material the use of which has not always been specifically authorized by the copyright owner. Such material is made available to advance understanding of ecological, political, human rights, economic, democracy, scientific, moral, ethical, and social justice issues, etc. It is believed that this constitutes a 'fair use' of any such copyrighted material as provided for in section 107 of the US Copyright Law. For more information go to: http://www.law.cornell.edu/uscode/17/107.shtml  If you wish to use copyrighted material for purposes of your own that go beyond 'fair use', you must obtain permission from the copyright owner.