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White House strikes Patients' Bill of Rights compromise
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WASHINGTON, D.C. — President Bush and Rep. Charles Norwood, MD, (R-Ga.) struck a deal late Wednesday night in an attempt to clear the way for House approval of a patients' bill of rights before Congress recesses for a month-long summer vacation.
Rep. Norwood had worked closely with Democrats on a bill the president promised to veto.
Dividing the Democrat-led proposal from the one favored by Republicans was the issue of where patients may sue their health insurance providers — the Democrats favor consumer-friendly state courts and the Republican measure favors federal courts.
The compromise will let patients sue insurance companies in state court and collect damages in cases where care has wrongly been denied. However, the cases would be governed by rules used in the federal court system, which mandates that patients exhaust all appeals to outside reviewers before suing, according to a brief statement by the White House.
The new deal puts a cap on damages as well, with punitive damages being limited to $1.5 million, and then only in cases where health plans ignore medical advice from independent reviewers. The compromise allows compensatory damage awards to reach $1.5 million as well. The original Norwood bill supported a $5 million limit on punitive damages and unlimited awards for compensatory damages. Mr. Bush favored a plan that would have barred punitive damages, and limited compensatory damages to $500,000.
Patients will still be allowed to sue HMOs, even if independent medical reviewers found no justification for their claims. The onus will be on the patient to disprove the reviewers' findings, as there will be a legal presumption that the decision of the external reviewers was correct.
The Senate passed a similar bill in June that gave patients a much broader right to sue health plans for improper denial of care.
A recent online poll found that half of Americans (52%) believe a $5 million limit should be placed on punitive damages awarded under the original Norwood bill; 31% said there should be no limit, and 17% agreed that the president's $500,000 proposed limit was adequate. An overwhelming 74% of respondents said they would consider changing their health plan coverage if their premiums increase as a result of the new legislation. The poll was conducted by www.ebix.com, and results were tallied before the Norwood-Bush compromise was announced.