Texas Asks SCOTUS to Uphold Patients’ Rights Provision

Texas Attorney General John Cornyn filed a petition with the Supreme Court yesterday asking it to uphold a provision of the state's patients' bill of rights that allows individuals to "seek an independent medical opinion if their insurers deny a treatment or test," the Dallas Morning News reports. Texas' law is "nearly identical" to an Illinois measure that the Supreme Court agreed to review after the 7th U.S. Circuit Court of Appeals in October 2000 upheld a "right to independent view" provision in the law. However, four months earlier in June 2000, the 5th Circuit Court of Appeals struck down the same clause in Texas' law, although the court upheld the general right of patients to sue their managed care organizations. The 5th Circuit in New Orleans ruled that the independent review requirement violated the 1974 Employee Retirement Income Security Act; the 7th Circuit in Chicago disagreed in its ruling on the Illinois case. John Roberts, an attorney for the defendant in the Illinois case, Rush-Prudential HMO, said the 5th Circuit's interpretation of ERISA was correct. "Congress thought it was better for both employees and employers to have uniform rules applicable nationwide." But Cornyn said yesterday: "This is about patients and their private physicians making health care decisions that affect them and their family, rather than accountants making those decisions." Since Texas' patients' rights law went into effect in 1997, insurers have won 42% of the more than 1,300 reviews by independent arbitrators, Cornyn said. The Supreme Court has not yet set a date to hear the Illinois case, which Cornyn said will "determine the fate of the Texas provision" (Lee, Dallas Morning News, 11/9).