MANAGED CARE REFORM: Assembly Passes HMO Liability Measure
The California Assembly late Thursday evening passed a bill (AB 2436) sponsored by state Assemblywoman Liz Figueroa (D) that would "let managed care patients sue their HMOs over bad medical decisions," the Orange County Register reports (5/30). While the measure passed 43-28, the Los Angeles Times reports that "[o]utraged Assembly Republicans caught Democrats casting 'ghost' votes for absent members on [the] key HMO bill, forcing the lower house to recess for several hours until two missing members returned from Los Angeles to cast crucial votes in person." Assemblymen Rod Wright (D) and Kevin Murray (D) flew back from Los Angeles to cast votes which colleagues had cast for them while they were back home in their districts. Assemblyman Dick Floyd (D) "never showed up" for the vote, although his name "remained among the measure's 'yes' votes, even on the final tally." The Times reports that Assemblyman Bill Leonard (R) "said that Assembly Republicans were tipped off to Democratic ghost votes by HMO industry lobbyists opposed to the bill." The Times notes that 41 votes are needed for a measure to pass in the Assembly. The measure now goes to the state Senate for consideration (Vanzi, 5/30).
Time To Face The Music
The bill would supersede the federal Employee Retirement Income Security Act (ERISA) and allow patients who are injured by their HMO's improper treatment decisions to sue for damages. "This was a tough battle, but the rights of patients to receive decent health care prevailed. The HMOs are making this bill their No. 1 priority, and they will fight me all the way. But I will not give up until patients can feel secure that good medicine, not the profit margin, is governing health care treatment decisions," said Figueroa. "Under AB 2436, if these huge for-profit corporations choose to ignore the health of patients, it will hit them where they understand it -- in their balance sheets," she added. Figueroa also said she believed the measure would be approved by the state Senate and sent to Gov. Pete Wilson (Figueroa release, 5/29). However, Wilson's "press secretary said Friday that the governor opposes the bill and prefers other pending measures that would set up independent panels to consider patient appeals of HMO denials of care" (Orange County Register, 5/30).
Consumer advocate groups hailed the bill's passage. Consumers for Quality Care says that AB 2436 "skirt[s] ERISA preemption because the bill provides damages for quality of care violations or medical negligence -- which courts have upheld as within the state's province -- instead of damages for bad faith and other coverage disputes, which are clearly preempted by ERISA." Jamie Court, director of the group, said, "It is only the threat of significant damages that will force billion dollar companies to provide timely and adequate treatment" (Consumers release, 5/30).