1601 N. Tucson Blvd. Suite 9
Tucson, AZ 85716-3450
Phone: (800) 635-1196
Hotline: (800) 419-4777
 Association of American Physicians and Surgeons, Inc.
A Voice for Private Physicians Since 1943
Omnia pro aegroto

Fletcher Patients' Rights Bill Attracts Two New Backers

Supporters of the patients' rights bill (HR 2315) backed by the House GOP leadership on July 19 "paraded" two additional Republican votes that they have "peeled away" from the rival bill sponsored by Reps. Charlie Norwood (R-Ga.), John Dingell (D-Mich.) and Greg Ganske (R-Iowa), CongressDaily/AM reports (Rovner, CongressDaily/AM, 7/20). Under the House leadership bill, sponsored by Rep. Ernie Fletcher (R-Ky.), patients could sue health plans in federal court for quality of care issues and non-quality of care issues, and could sue in state court only in cases in which health plans refused to abide by decisions made by outside appeals panels. The bill would cap non-economic damages in federal court at $500,000, but state courts could award as much money in damages as the state allows. The legislation would prohibit punitive damages (Kaiser Daily Health Policy Report, 7/9). The Norwood-Ganske-Dingell bill would allow patients to sue HMOs in state court for denial of benefits or quality of care issues and in federal court for non-quality of care issues. The legislation would cap damages awarded in federal court at $5 million, but state courts could award as much in damages as the state allows. Although House leaders won the support of Reps. Spencer Bachus (R-Ala.) -- one of the 18 Republicans who voted for a bill similar to this year's Norwood-Dingell-Ganske measure in 1999 -- and John Cooksey (R-La.), they "conced[e]" that they do not have majority backing for their bill. "If we had the votes right now, we'd put it on the floor tonight," Fletcher said. Bachus and Cooksey said that the Fletcher bill would raise health care costs "by far less" than the Norwood-Dingell-Ganske measure. Despite the new support for the Fletcher bill, Norwood said that he "remains confident of his votes," adding, "We won't win by as much as last time, but we'll win."

Ironing out Differences

On July 19, Norwood, Dingell and Ganske introduced a new version of their legislation that includes amendments adopted in the Senate bill (S 1052) passed last month. While the new measure adopts language from the Senate bill on employer liability, exhaustion of administrative appeals and limits on class-action suits and attorney fees, it does not include all of the Senate amendments. For example, the new House bill drops a Senate amendment that would ban genetic discrimination, a provision that some Democrats said should "move on its own track." The new House bill also includes additional language not in the Senate bill, including a provision to "clarify that this legislation does not create new liability for treating physicians, treating health professionals or treating hospitals." The new House bill also "says patients cannot be required to submit to arbitration instead of exercising the rights included in the bill."

Nickles Amendment Rewrite

In addition, the new House bill "significantly rewrites" an amendment sponsored by Sen. Don Nickles (R-Okla.) that would allow federal employees, as well as Medicare and Medicaid beneficiaries, to sue federal health plans in state court (CongressDaily/AM, 7/20). The Nickles amendment "jolted" Federal Employees Health Benefits Plan insurers, who warned that the provision would prompt "significant" premium increases. Under the new language, the amendment would require the president to issue an executive order directing officials who administer federal health plans, "to the extent feasible, to take such steps as are necessary to implement the rights and privileges" under the patients' rights legislation (Barr, Washington Post, 7/20). The new language would also require the General Accounting Office to submit a report to "determine what steps would be necessary to apply the bill to all federal health insurance programs" (CongressDaily/AM, 7/20). According to the Washington Post, the modified language "seems to recognize that the FEHBP and other government health programs ... operate under different rules than private sector plans" (Washington Post, 7/20). Tax Provisions The new House bill also includes a number of tax breaks not in the Senate bill, which sponsors hope will "win support" from House Republicans. The provisions would expand tax-exempt medical savings accounts that people could use to cover health care costs, allow a tax credit of up to $2,000 per family to help low-income employees purchase health insurance and permit self-employed people to deduct the full cost of health insurance premiums from their income taxes (McQueen, Associated Press, 7/20).