House-Senate Patients’ Rights Meetings to Focus on Suits
House and Senate negotiators will face "thorny political strategy decisions and tense policy negotiations" when they meet next month to resolve differences between the patients' rights bill (HR 2653) passed in the House earlier this month and the bill (S 1052) that the Senate approved in June, CongressDaily reports. The "key difference" between the two bills concerns "how and under what circumstances a patient can take an HMO to court over an injury" (Fulton, CongressDaily, 8/15). Under the House bill, patients could sue health plans in state courts -- generally considered more favorable to plaintiffs -- under a new set of federal rules that would cap non-economic damage awards at $1.5 million. Courts could award patients 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 an HMO "still persists in refusing the care they need" (California Healthline, 8/2). The Senate 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 (California Healthline, 2/7).
The question of whether a federal patients' rights law would override state laws is also up for debate. Rep. Charlie Norwood (R-Ga.), who brokered the compromise with President Bush that "propel[led]" the House bill to victory, said that the deal would allow state patients' rights laws to remain in place, but Democrats "contend" that the bill would override state laws. Still, lawmakers said they are "optimistic" about the conference. Aides said that although patients' rights legislation has died in conference in the past, the "dynamics are different" this time because President Bush "insists he wants to sign a bill" and the Democratic Senate "can pull up stakes in the conference if it is not going the way they want." Aides said that staff members have had few discussions to prepare for conference, but predicted that they would hold "more intense meetings" at the end of month, before Congress returns from the August recess (CongressDaily, 8/15).