Rep. Norwood Revives Patients’ Rights Debate with New Legislation
Rep. Charlie Norwood (R-Ga.) is "reviv[ing]" the debate over patients' rights by proposing two new bills, but he acknowledged that passage of such legislation "could be difficult" because lawmakers recently have been focused on creating a Medicare drug benefit and addressing rising medical malpractice insurance rates, the Associated Press reports (Abrams, Associated Press, 2/5). In the 107th Congress, the House and Senate each approved patients' rights legislation, but negotiations to reconcile the two separate bills stalled over the issue of caps on damage awards in lawsuits against health plans. The Senate bill would have allowed consumers to sue HMOs in state court for unlimited damages or in federal court, with any damages limited to $5 million. The House bill, supported by the Bush administration, would have permitted consumers to sue HMOs only in federal court, with a $1.5 million cap on noneconomic damages. Consumers also would have been permitted to receive up to $1.5 million in punitive damages under the House bill, but only if they had won complaints against the HMO before an outside appeals panel and the HMO still refused to cover the cost of care (California Healthline, 11/22/02). Norwood's first measure, the Patient Protection Act, would require that people enrolled in managed care programs have access to emergency and pediatric care, as well as prescription drugs. The act would also guarantee patients' access to information, "protect" the doctor-patient relationship and grant patients the right to an independent review when a doctor and an insurance company disagree on a treatment (Associated Press, 2/5).
The measure has been modified to reflect the Supreme Court's ruling in Rush v. Moran, by allowing states to have "more stringent" independent review provisions than the minimum established by federal law (Norwood release, 2/5). In that case, the high court upheld state laws allowing consumers the right to seek an independent review of denials of care by managed care companies. The court determined that HMOs regulated by state laws are a form of insurance and an employee benefit and thus states' authority to regulate them is not "pre-empted" by the 1974 Employee Retirement Income Security Act. ERISA, implemented to provide national uniformity in employee benefits, overrides any state statute dealing with employee benefit plans except for the regulation of insurance (California Healthline, 6/21/02). Norwood's second measure, the ERISA Clarification Act, also reinforces the Supreme Court's Rush v. Moran decision, stating that ERISA does not block actions against health plans for denials of care from proceeding in state courts (Norwood release, 2/5).
"I know others will say that with health care costs on the rise, now is not the time for patient protections; but from my perspective, now is precisely the time for patient protections. When insurers and employers are concerned about the cost of health care, the quality of patient care can be jeopardized for the bottom line," Norwood said (Norwood release, 2/5). His measures have "attracted little support" so far, in part because they do not include a provision for suing managed care plans for medical decisions, CongressDaily/AM reports (Rovner, CongressDaily/AM, 2/6). Norwood said, "I am no longer trying to help forge a compromise on liability. I tried that for years and, in the end, all I got was a few hundred beatings and no law." However, Rep. John Dingell (D-Mich.), who previously cosponsored a patients' rights bill with Norwood, said that trying to pass a patients' rights measure without addressing the liability issue is "like trying to move a car forward without an engine" (Associated Press, 2/5). Sen. John McCain (R-Ariz.) said that a liability provision "has to be part of any [patients' rights] package." Sen. John Edwards (D-N.C.) added, "Without enforcement, it's a patients' bill of suggestions." Dingell, McCain, Edwards and Sen. Edward Kennedy (D-Mass.) are expected to propose their "latest version" of a patients' rights bill "in the next few weeks," CongressDaily/AM reports (CongressDaily/AM, 2/6). Dr. Donald Young, president of the Health Insurance Association of America, said Norwood's "legislation ... would further drive up health care costs, exacerbating the nation's uninsured crisis at a time when health care costs already are escalating rapidly" (Associated Press, 2/5).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.