PATIENTS’ RIGHTS: Push For ERISA Reform Continues
Today's Los Angeles Times reports that there is a "growing push by federal and state legislators to overhaul" the 1974 Employee Retirement Income Security Act (ERISA) to allow consumers to "sue their health plans -- and their employers." The Times also notes the growing "frustration" among federal judges at their inability "to punish HMOs and insurance companies for misconduct." In 1987, the Supreme Court "held that ERISA barred consumers and their relatives from recovering damages" from employer-sponsored plans, and since then "federal judges say they have no choice but to dismiss ... suits against insurers and HMOs because ERISA demands it." One judge presiding over a case where an HMO was being sued for denial of treatment said there is a "glaring need for Congress to amend ERISA to account for the changing realities of the modern health care system." But industry groups are lobbying hard to keep the ERISA provision in place. "The present system works well, and allowing damages to be levied against health plans or employers is not going to assure that the benefits themselves will be delivered," said ERISA Industry Committee President Mark Ugoretz (Maharaj, 9/16).
On The Floor
CongressDaily reports that Senate Democrats yesterday "renewed their push for a debate on managed care legislation." At a press conference, Sen. Edward Kennedy (D-MA), ranking member of the Senate Labor and Human Resources Committee, said the Democrats' Patients' Bill of Rights "will be on the floor this week in one form or another." CongressDaily reports that "Kennedy again slammed" the Senate GOP leadership's parliamentary decision to allow each side to add only three amendments per bill. A "Senate Democratic aide declined to identify the bill to which the managed care measure will likely be offered as an amendment," but added that the Senate calendar presents "a target-rich environment right now" (9/16).