AMA States Objection to Frist Patient’s Rights Proposal
The American Medical Association on May 23 stated its "formal" opposition to a patients' rights bill (S 889) sponsored by Sens. Bill Frist (R-Tenn.), James Jeffords (I-Vt.) and John Breaux (D-La.), saying it "does not go far enough" towards protecting patients, CongressDaily/AM reports. Speaking at a press briefing, AMA immediate past President Thomas Reardon said that not only does the measure "fall seriously short when it comes to offering patients protections against managed care abuses," in some cases "the bill actually takes away important protections patients now have" (Rovner, CongressDaily/AM, 5/24). The Frist-Breaux-Jeffords measure would give all patients with private health insurance a limited right to sue their health plans after exhausting an appeals process by an outside review panel. Patients could only sue health plans in federal court, not state court, and awards would be capped at $500,000 (Kaiser Daily Health Policy Report, 5/16). According to a "detailed analysis" conducted by the AMA, the measure "would override laws in nine states that currently allow patients to sue health plans in state courts and would roll back emerging federal case law on the subject." The AMA also said that the bill's requirement that state laws on patients' rights be only "consistent with" federal requirements would, in effect, allow states to have weaker laws than the federal standard. "With all due respect to Sen. Frist, America's patients deserve better than this," Reardon said.
Point Taken, Point Given
Addressing the AMA's criticism, aides to Frist and Jeffords "conceded" that the association was correct in saying that the bill would permit state laws to differ from federal standards. However, a Frist aide said the reason was to prevent states that already have patient protection laws from having to "refight settled battles." Aides called other AMA concerns "unfounded," with a Jeffords aide saying that the bill is not intended to override state right-to-sue laws and adding, "We believe we've explicitly protected laws like Texas'," which includes a right to sue.
Across the Capitol
Meanwhile, in the House, Rep. Ernie Fletcher (R-Ky.) has produced a "discussion draft" of a bill that would allow a "very limited universe of suits to proceed in state court," including "those in which a managed care plan failed" to follow the decision of an external review panel, CongressDaily/AM reports. However, backers of the patients' rights bill (S. 283) sponsored by Sens. John McCain (R-Ariz.), John Edwards (D-N.C.) and Edward Kennedy (D-Mass.) have called Fletcher's proposal "unacceptable" (CongressDaily/AM, 5/24). The McCain-Kennedy-Edwards bill would allow patients to sue HMOs in state court for denial of benefits or quality of care issues and in federal court for non-quality of care issues, such as those involving violations of their health plan's contract. Damages awarded in federal court would be capped at $5 million, but state courts could award as much money in damages as the state allows (Kaiser Daily Health Policy Report, 2/7).
