Appointing Conferees on Patients’ Rights Could Prompt Filibuster, Daschle Says

Senate Majority Leader Tom Daschle (D-S.D.) on June 4 said that a motion to appoint Senate conferees to negotiate an agreement with the House on "long-stalled" patients' rights legislation could lead to a filibuster, CongressDaily/AM reports (Rovner/Fulton, CongressDaily/AM, 6/5). Although both the Senate and House passed patients' rights bills last year, Daschle has delayed the appointment of conferees to allow the sponsors of the Senate version of the bill -- Sens. Edward Kennedy (D-Mass.), John Edwards (D-N.C.) and John McCain (R-Ariz.) -- to negotiate an agreement with the White House, which supports the House bill. The Senate bill would allow patients to sue HMOs in state courts -- which often award larger damages than federal courts -- for denial of benefits or quality of care issues and in federal court for non-quality of care issues. The legislation would cap damages awarded in federal court at $5 million but would allow state courts to award as much in damages as states allow. The House bill would allow patients to sue health plans in state courts only for non-economic damages up to $1.5 million. In addition, the legislation would allow courts to award patients up to $1.5 million in punitive damages, but only in cases where patients won complaints against health plans before an outside appeals panel and an HMO still refused to provide care (Kaiser Daily Health Policy Report, 5/22). Negotiations between Kennedy and the White House have stalled, "primarily" over the question of caps on damage awards. McCain said, "Sooner or later, they'll move ahead with conferees. But I fear that's not going to get us anywhere. We're rapidly approaching the point where this is going to be a political issue in the 2002 elections" (CongressDaily/AM, 6/5).

Supreme Court Case
Meanwhile, an upcoming Supreme Court decision in the case of Rush Prudential HMO Inc. v. Moran and State of Illinois -- which will determine whether the 1974 Employee Retirement Income Security Act, which regulates employee benefit plans, overrides an Illinois law that requires an independent review in disputes between a patient's primary care physician and a health plan over coverage decisions -- could "reinvigorate" the patients' rights debate, CongressDaily reports (CongressDaily, 6/4). The patients' rights bills passed in the Senate and House last year would require independent reviews to resolve patient disputes with health plans and would override the Supreme Court's decision in the case and apply nationwide, regardless of state laws (Kaiser Daily Health Policy Report, 1/11). Karen Ignagni, president and CEO of the American Association of Health Plans, which filed an amicus brief on behalf of Rush Prudential, on June 4 said that Congress "should proceed with caution before moving forward with a bill that would increase health care mandates" (CongressDaily, 6/4).