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Lack of consensus could delay vote on Republican HMO
bill
Posted
9-20-99 Washington. House Republicans introduced a broad HMO-reform bill early this month that would allow patients to sue health plans for injuries caused by the insurer's negligence. A vote on the measure before the full House was expected later this month, but may be delayed because of rancorous debate among party leaders over the controversial issue. Speaker J. Dennis Hastert, R-Ill., was still resisting endorsement of the bill late last week. The authors of the bill, Reps. Tom A. Coburn, R-Okla., and John Shadegg, R-Ariz., said it would protect patients by letting them sue in federal court to collect damages for genuine injuries while keeping the courts clear of frivolous lawsuits. The bill would allow patients to sue if they suffered physical injury at the hands of a health plan. Before taking action in court, however, patients would have to exhaust the insurer's own appeals process. Damages for pain and suffering would be limited to a maximum of $250,000. Consumer groups immediately criticized the bill as a political maneuver to derail a rival Democratic bill that includes the right to sue and puts no cap on the damages HMOs could pay. "This [Republican] measure doesn't really produce enough incentive for the plans to provide quality care," said Adrienne Hahn, legislative counsel for Consumers Union. "As long as there is a cap on damages, the rest of the reform language is just words on paper. They'll just do a simple cost-benefits analysis and decide that it's cheaper not to change the way they deliver care." American Association of Health Plans President Karen Ignangni said giving patients the right to sue HMOs would raise health insurance premiums. "Congress should either support keeping coverage affordable through a system of external review, or they can cast their lot with the trial lawyers," Ignangni said.
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