The agreement reached by House-Senate conferees in mid-April over external appeals in the Patients’ Bill of Rights bill won’t be worth the paper it’s written on unless it is followed up by allowing people to sue their HMOs over denial of care, says the measure’s main House sponsor.
A spokesman for Rep. Charlie Norwood, a Georgia Republican and dentist, said there is much to praise in the external appeals agreement reached by conferees, but there are also many potential loopholes for HMOs if Congress doesn’t ultimately enact the bill with strong liability provisions.
The bill has been mired in a politically-charged House-Senate conference committee. Whether there will be action in May when Congress returns from an Easter recess is uncertain and may depend on how political winds are swirling. The bill passed the House last October, 257-211, but Speaker Dennis Hastert (R-IL) chose to appoint to the Conference Committee only House members who voted against the bill.
Although the partial agreement in April does not address the contentious right-to-sue and scope of coverage issues, which will be debated following resolution of final external appeals language, it does represent the most significant agreement Democrats and Republicans have had on the patient’s rights legislation to date.
John Stone, Norwood’s press aide, expressed pessimism that enough time remains to iron out the scope and liability issues, although there is talk that conferees hope to put the final touches on the proposal before the July 4 holiday break.
“It’s taken the conferees six weeks just to agree on terms like “medical necessity,” Stone said. “It’s getting harder and harder to believe that the House and Senate can reach agreement over the really important parts of the bill.”