GOP Bill Aims to Limit HMO Lawsuit Liability: Patients Would Face Strict Standards

By Boyer, Dave | The Washington Times (Washington, DC), August 21, 1999 | Go to article overview

GOP Bill Aims to Limit HMO Lawsuit Liability: Patients Would Face Strict Standards


Boyer, Dave, The Washington Times (Washington, DC)


Republicans yesterday presented a managed care reform bill that would require patients to meet strict medical and legal standards before they could bring federal suits against their HMOs for delayed or denied care.

A draft of the proposal, which Republican leaders agreed to schedule for a floor vote to head off a bipartisan plan with fewer restrictions on lawsuits, was released at an American Medical Association policy meeting in Chicago.

The bill, which has yet to receive final approval from House Speaker J. Dennis Hastert, would give patients the right to sue in federal court if an HMO's action caused them harm. But it would include protections against employers being sued.

An aide to Rep. Porter J. Goss, Florida Republican and point man for Mr. Hastert on the issue, said the bill is nearly ready for introduction. "We've made a lot of progress," said Darren Willcox, legislative director for Mr. Goss.

But a Republican leadership aide said Mr. Hastert still has not approved the liability provisions.

"We don't feel like we're quite there yet," he said. "That [liability] is what we're trying to negotiate."

The aide said one of the bill's sponsors, Rep. Tom Coburn, Oklahoma Republican, released his proposal to the doctors' group because "he's trying to keep the AMA on board. He really wants to have their support."

HMO liability is a difficult issue for Mr. Hastert. A Senate-passed bill does not enable patients to sue their HMOs. But the bipartisan House plan would allow patients to sue their health-care plans in state court for compensatory and punitive damages if they were improperly denied care.

Faced with that measure, Mr. Hastert agreed just before Congress began its August recess to schedule a floor vote on a more modest proposal offered by Mr. Coburn and Rep. John Shadegg of Arizona.

Aides have been trying to come up with narrow guidelines for lawsuits that are acceptable to Mr. …

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