Tennessee, West Virginia Lawmakers Debate Patients’ Rights Alternatives
A Tennessee lawmaker has introduced an "alternative" state patients' bill of rights proposal designed to address Gov. Don Sundquist's (R) concerns that the two leading House versions, which would allow patients to sue their health plans, would drive up health insurance costs and cause employers to drop coverage, the Nashville Tennessean reports. Last year, a patients' rights bill sponsored by Rep. Gary Odom (D) passed the House twice, but both times the measure died in the Senate, which placed it in a study committee. This year, that committee has "emerged" with a bill similar to Odom's: Both would allow punitive damages and uncapped pain and suffering damages. However, late last month, the House Judiciary Committee delayed action on both these measures so it could consider a new proposal, which would create a two-tier level of review, "would limit court judgments for pain and suffering to $300,000, ... would not permit punitive damages" and would cap attorney fees. John Tighe, deputy to the governor for health policy, told lawmakers that the governor is concerned that a high liability limit would cause small business to drop coverage of employees, leading "more people ... onto the already strapped" rolls of TennCare, the state's Medicaid managed care program. However, Odom criticized the new proposal as being too "industry-friendly," saying it required Tennesseans to "jump through many hoops before they can sue" (de la Cruz, Nashville Tennessean, 3/29).
A Multi-Front Battle
Writing in an op-ed for the Memphis Commercial Appeal, reporter Paula Wade notes the difficulty the Tennessee General Assembly faces in crafting a patients' bill of rights, as it involves four big special-interest groups. She writes, "HMO liability pits trial lawyers (who want the business of suing deep-pocket insurers for big bucks) and doctors (who resent having to play Mother-may-I with bureaucrats who never answer the phone) against business groups (which fear higher insurance premiums) and the insurance industry (which fears being hammered by big-dollar lawsuits)." Wade notes that state lawmakers have successfully killed several patients' rights bills using parliamentary and delay tactics. And while legislators are aware that public opinion is strongly in favor of giving patients the right to sue health plans, she concludes that getting to that result "won't be pretty" (Wade, Memphis Commercial Appeal, 4/5).
Movement in West Virginia
In related news, the West Virginia House Judiciary Committee on March 19 approved a patients' bill of rights containing a provision for suing a health plan, the AP/Charleston Daily Mail reports. Under the measure, similar to a proposal offered by Gov. Bob Wise (D), patients would first have to pursue a complaint through their insurers' internal grievance process. If denied, patients could then appeal to a panel composed of three physicians, which could require an HMO to provide the coverage in question if determined that it is medically necessary. HMOs that fail to comply with the panel's finding could then be sued in state civil court (AP/Charleston Daily Mail, 3/20).
