Bush, Norwood Reach Compromise on Patients’ Rights, Vote Expected

After weeks of negotiations, President Bush and Rep. Charlie Norwood (R-Ga.) reached a compromise yesterday on patients' rights legislation, "clearing the way for House passage" this week, the New York Times reports (Pear, New York Times, 8/2). The deal would allow patients to sue health plans in state court -- generally considered more hospitable to plaintiffs -- under a new set of federal rules that would cap non-economic damage awards at $1.5 million. Patients could also be awarded up to $1.5 million in punitive damages, but only in cases where patients win complaints against health plans before an outside appeals panel and where an HMO "still persists in refusing the care they need." In addition, patients could sue health plans after an outside review panel rejects their complaints, but lawsuits in those cases would "have a much higher burden of proof to overcome." The agreement would allow patients to sue large employers that administer their own health plans over health care disputes in federal court, not state courts (Goldstein/Eilperin, Washington Post, 8/2). House Republicans will likely offer the agreement today as an amendment to the patients' rights bill (HR 2563) sponsored by Norwood and Reps. John Dingell (D-Mich.) and Greg Ganske (R-Iowa) (New York Times, 8/2). That bill, which is similar to the patients' rights bill (S 1052) passed by the Senate in June, 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. In addition, the bill would cap damages awarded in federal court at $5 million, but state courts could award as much in damages as the state allows.

Supporters of Ganske-Dingell-Norwood "immediately condemned" the proposal as "inadequate" (Koszczuk/Hutcheson, Philadelphia Inquirer, 8/2). According to some, the deal would "preserve a privileged status" for health plans and could "jeopardize" state patients' rights laws (Miller, Los Angeles Times, 8/2). The agreement "favors the HMO over the patient," Sen. John McCain (R-Ariz.), who co-sponsored the Senate bill, said (Epstein, San Francisco Chronicle, 8/2). Democrats "fear" that provisions in the agreement "will prove cumbersome and unworkable" (Rogers, Wall Street Journal, 8/2). Some supporters of Ganske-Dingell-Norwood have said that they "won't agree to the deal" (Welch/Keen, USA Today, 8/2). "Charlie cut his own deal," Ganske said, adding, "I think Charlie looks a little worn out. I guess they just beat him down" (Malone/Eversley, Atlanta Journal-Constitution, 8/2). However, Norwood said, "The bottom line and the goal is that we want to change the law, and the last time I looked, that's pretty difficult to do without the presidential signature" (Hutchinson, New York Daily News, 8/2).