Newspaper article The Florida Times Union

House, Senate at Odds over Suits against HMOs

Newspaper article The Florida Times Union

House, Senate at Odds over Suits against HMOs

Article excerpt

TALLAHASSEE -- House leaders took the rare step of closing a health maintenance organization reform bill to amendments yesterday, sparing representatives the necessity of voting on the politically touchy issue of allowing lawsuits for damages against HMOs.

Currently, lawsuits against HMOs are limited to breach of contract.

Democrats said the Republicans were ducking the issue and denying them a chance to debate the amendment, even though its chances of passage were slim.

Rep. Debbie Wasserman Schultz, D-Davie, said the closing of the bill for only the third time since the rule allowing such action was passed in 1997 was "a purely political action."

"They don't want to cast a vote that will be unpopular in their district," she said.

House and Senate leaders agree something needs to be done about improper denial of treatment, but the issue of whether to allow lawsuits means there will be hard bargaining in the final days of the session, which ends May 5.

The Senate Health, Aging and Long-term Care Committee approved a bill that includes the right to sue for compensatory and punitive damages by a 6-0 vote yesterday, although two of the members said they had concerns about lawsuits.

Senate Republican Leader Jack Latvala of Palm Harbor said the provision was narrowly drawn and only allowed suits if the HMO's own doctor said the treatment was needed and the organization failed to grant the request within 60 days after the patient appealed. It wouldn't allow punitive damages unless the act is part of an ongoing pattern, is malicious or reckless.

"The House of Representatives has a patient protection bill that was written by the industry," Latvala said. "Absolutely, totally written by the industry and that's wrong."

But Jodi Chase, a lobbyist for Associated Industries of Florida, said the proposal would raise costs and drive HMOs out of the state.

"Right to sue is a horrible idea," she said, citing the financial problems of nursing homes, which are subject to suits.

Lawmakers were caught between those urging greater protections for patients and those warning that employees could lose their insurance if costs got too high.

Hank Madsen, owner of a Tallahassee printing business, said he would be forced to drop coverage for his 30 employees if premiums got any higher.

But Latvala said he runs a small direct mail advertising business and his employees struggle with HMO paperwork and loopholes that make it difficult to collect on legitimate claims.

The right to sue would provide a hammer over the head of the HMOs to make them do the right thing, Latvala said.

Things looked very different in the House General Appropriations Committee, which passed a patient protection bill without a lawsuit provision by a 17-3 vote. …

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