HMO REFORM: Lawmakers Play It Again

      Sen. Tom Daschle (D-SD) Tuesday introduced in the Senate a Patients' Bill of Rights that is virtually identical to legislation he offered last year that failed to gain Senate approval. Reuters Health reports that S.6 "contains the provisions highlighted by President Clinton in his State of the Union speech," such as coverage of emergency room care, access to specialists, independent reviews and the right to sue health plans ( see yesterday's CHL) (1/21). According a Daschle press release, "Democrats are committed to keeping managed care reform at the forefront of congressional debate," and will make it their "number one legislative priority" (release, 1/21). "We are pleased that our Republican colleagues say HMO reform will be a priority this year as well," said Daschle in a Tuesday statement. "The plan they offered last year covered only one in three privately insured Americans and contained other major holes as well. We hope their new proposal will correct those problems," he added. HIAA President Chip Kahn said Daschle's bill would "weaken the ability of managed care plans to control costs and combat waste, fraud and abuse" and would "discriminate against the uninsured because it would impose additional roadblocks to affordable coverage" (Reuters Health, 1/21).

Hastert Speaks
      In his "first comments on the health issue since taking over the speakership," House Speaker Dennis Hastert (R-IL) is expected today to tell fellow representatives the House will vote on patient protection legislation this year. CongressDaily/A.M. reports that in a "Dear Colleague" letter, Hastert said this year "the committee chairman of jurisdiction will begin to address the patient protection issue in a timely and thorough manner." Reminding Congress members that he has "not been shy about advocating a process where patients receive care in hospital rooms, not courtrooms," Hastert wrote that he "will continue to support real change that does not significantly increase costs or cause more people to lose coverage."

Groundhog Day
      In related news, Rep. Michael Bilirakis (R-FL), chair of the Commerce Committee's health subpanel, announced in a "Dear Colleague" letter that he plans to reintroduce the Republican Patient Protection Act Feb. 2. The measure narrowly passed the House last year, CongressDaily/A.M. reports (Rovner, 1/21).

Move To Sue?
      Testifying before the Senate Health, Education, Labor and Pensions Committee yesterday, a Labor Department official advocated right-to-sue regulations. Leslie Kramerich, deputy assistant secretary for policy at the Labor Department's Pension and Welfare Benefits Administration, "said the administration plans to move ahead with regulations published Sept. 9, 1998 that would revise minimum standards relating to benefit claims procedures for all employee benefit plans covered by ERISA." CongressDaily/A.M. reports that these regulations would require plans to process emergency room care claims more quickly and to refer claims appeals to those in authority over those who denied the original claims. Kramerich also "said the administration supports creating an external review process, but that legal recourses also must be made available" (Morrissey, 1/21).