Patients’ Rights Bill Cues Showdown on HMO Suits

A key Senate ally of President Bush will propose a patients’ bill of rights today that would give new protections to patients while setting strict limits on court awards against health plans accused of misconduct.

The bill’s long-awaited introduction by Sen. Bill Frist (R-Tenn.) could trigger a major health care fight on the Senate floor pitting the Bush administration against Sens. John McCain and Edward M. Kennedy, who favor similar patient protections without such strict limits on lawsuits against health maintenance organizations and insurers.

Currently, patients have little legal recourse against HMOs and other health plans.

Co-sponsored by Sens. John B. Breaux (D-La.) and James M. Jeffords (R-Vt.), Frist’s bill would require patients to exhaust an independent medical review process before taking disputes against HMOs and health insurers to federal court.

Once in court, damage awards would be capped at $500,000 under the bill, Breaux said.

Frist drew up his plan after Bush and groups in the managed care industry objected to the more sweeping patients’ bill of rights introduced by McCain (R-Ariz.), Kennedy (D-Mass.) and John Edwards (D-N.C.).

Like Frist’s bill, that measure would ensure that all 167 million Americans with private health insurance have access to emergency and specialty care.

But McCain, Kennedy and Edwards also would permit jury awards of up to $5 million in federal court and unlimited punitive damages under state law.

But since its introduction, the $5-million cap has drawn heavy fire from insurance companies and health plan providers, who warned that the bill would trigger a flood of frivolous lawsuits.

Bush, in turn, threatened to veto the bill.

Undeterred, McCain and Edwards said they may propose their patients’ bill of rights as an amendment to the Senate’s far-reaching education reform plan, Bush’s top legislative priority.