Patients Rights Act of 1999:
House and Senate Differences
Dateline: 10/10/99
The Senate and House have now passed their own version of a major health care bill designed to protect the rights of patients in dealing with their HMO (Health Maintenance Organization). This feature summarizes differences between the House and Senate versions of this important legislation.
The Senate Version
S. 1344 - "A bill
to amend the Public Health Service Act, the Employee Retirement Income Security Act of
1974, and the Internal Revenue Code of 1986 to protect consumers in managed care plans and
other health coverage." - passed by a 53 - 47 vote on July
15, 1999.
The House Version
H.R. 2723 - "A
bill to amend title I of the Employee Retirement Income Security Act of 1974, title XXVII
of the Public Health Service Act, and the Internal Revenue Code of 1986 to protect
consumers in managed care plans and other health coverage." - passed by a vote of 275
- 151 on October 7, 1999.
Differences Between the Two Bills
Coverage Provided
House Version
All Americans (161 million) would be covered by private health insurance.Senate Version
Many provisions would apply only to Americans participating in existing federally regulated plans like Medicare. (About 48 million persons.)
Patients' Right to Sue
House Version
An existing ban on suits for Americans covered by federally regulated health plans would be lifted. Injured patients could sue in state or federal courts for unlimited damages.Senate Version
No new rights to sue are provided.
Care by Obstetricians and Gynecologists
House Version
Women would be allowed to see these specialists without prior approval and without declaring them as primary care physicians.Senate Version
Same provisions, but would apply only to federally regulated health plans.
Emergency Room Care
House Version
Health plans would be required to pay for reasonable emergency room services without prior approval.Senate Version
Same provisions, but would apply only to federally regulated health plans.
Appeals Process
Both House and Senate bills would allow patients to appeal coverage denials to physicians and experts outside the involved health plan.
A conference committee made up of members of both House and Senate will now work to resolve differences between the two bills.
Can
You Sue Your HMO?
About.com's Guide to Mental Health
Resources, Dr. Leonard Holmes, Ph.D. offers a detailed examination of your rights in
suing your health plan provider.
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