Supreme Court Ruling Should Lead to Passage of Federal Patients’ Rights Law, Los Angeles Times Says

The U.S. Supreme Court's recent ruling upholding state laws that require an independent review in cases where an HMO denies care should "[i]deally" inspire Congress to pass a patients' bill of rights, a Los Angeles Times editorial says. Although the ruling is "no more than common sense," it only applies to individuals who are not enrolled in self-insured employer-based health plans. A federal patients' rights law would ensure that individuals in self-insured plans also have access to independent reviews and would avoid a "crazy quilt of conflicting state regulations," the editorial says. Current patients' rights legislation has "languished" in Congress because of disagreement between Senate Democrats and House Republicans over whether to cap damage awards; Democrats favor damages with higher limits than Republicans. The "logical compromise" would be to require HMOs to accept an individual review panel's decision and cap the amount of damages for pain and suffering, the Times states, adding that if Congress approves a patients' rights bill that centers around a "moderate independent review process," it would establish an "informal body of case law" that would prevent future lawsuits and help HMOs control costs. The editorial concludes, "Patients also would get what Daniel Zingale, director of California's Department of Managed Health Care, says they want most: the right 'to see a doctor, not a lawyer. They want the care before the damage is done, rather than suing after the fact'" (Los Angeles Times, 6/24).