Friday, March 26, 1999
Right to sue HMOs to be stripped from Ohio bill
Opponents say Taft idea would drive up insurance
BY MICHAEL HAWTHORNE
Enquirer Columbus Bureau
COLUMBUS — It appears Ohioans won't be able to sue their HMOs for refusing to pay for medical treatments.
Two months after Republi can Gov. Bob Taft made HMO liability the linchpin of his “Patient Protection Plan,” a GOP-controlled House committee is moving to strip out the provision, The Cincinnati Enquirer has learned.
“If we really want to help patients get through the system, this is not the way to go,” said Rep. Dale Van Vyven, R-Sharonville, chairman of the House Health Retirement and Aging Committee. “We want to make this as simple as possible.”
Mr. Van Vyven said Thursday he decided to remove the liability provision after weeks of hearings dominated by opposition from business and insurance interests, which contend health insurance would become more expensive if patients could sue their HMOs.
Opponents of House Bill 4 also represent two of the main sources of campaign contributions for Republican candidates.
Scott Milburn, spokesman for Mr. Taft, said the new governor still supports the liability provision. But Mr. Taft has signaled he may settle for a bill that doesn't allow the 2.8 million Ohioans covered by HMOs to take their complaints to court.
“Any legislation that contains any part of our health-care proposal is worthy of support,” Mr. Taft said when he unveiled his legislative agenda in January. “I'm hoping to make as much progress as we can.”
Lawyers, doctors and consumer groups argue the fear of being sued would make HMOs more likely to pay for early, more affordable care. They have tried to sway reluctant legislators with emotional stories of patients whose requests for treatments have been turned down.
“Based on my own personal experience, I believe that having the ability to bring a negligent denial of health care lawsuit will, by itself, go a long way toward making (HMOs) act more responsibly,” said Columbus attorney Elizabeth Burkett, a representative of the Ohio Academy of Trial Lawyers.
However, most supporters acknowledge they are unlikely to win support from a Republican-controlled General Assembly that already has moved to curb liability lawsuits.
Andrew Doehrel, president of the Ohio Chamber of Commerce, said he and other opponents have reminded Republican lawmakers of their previous votes on lawsuit reform.
“We went to war on that issue, only to see the same people come back and try to add another layer of liability,” Mr. Doehrel said. “It doesn't make sense.”
After managed-care reform became a hot political issue last summer, Mr. Taft issued a proposal that was strikingly similar to one introduced months earlier by his Democratic rival, Lee Fisher.
In addition to allowing patients to sue their HMOs, the bill backed by Mr. Taft would speed up appeals of denied coverage, guarantee payments for emergency care and allow women to see their gynecologist or obstetrician without a referral.
The measure also creates new tax breaks for medical care, long-term care and medical expenses.
Legislative leaders are gathering interested parties to discuss a compromise that would replace HMO liability with binding, independent review of patient complaints, said sponsoring Rep. Randy Gardner, R-Bowling Green.
State law requires external review only in cases where treatments for terminal illnesses have been denied.
It's unclear who would conduct the additional reviews or who would have the power to choose the reviewers. But at least one supporter of HMO lawsuits is willing to consider the idea.
“Our goal is to create something that doesn't take four or five years to resolve,” said Tim Maglione, director of legislation for the Ohio State Medical Association. “The bottom line is achieving something that boosts consumer confidence and improves their care.”
Bill and his 'boy' hash things over
Sixth-graders' loyalties tested by suspension
Ohio city restricts car-phone users
Police official joins memorial to shooting victim
Slaying suspect called jealous
Therapists OK trash-can mom for trial
Airline exchanges trips for food donations
Freedom Center's plans ambitious
Penguins waddle in, settle down
Right to sue HMOs to be stripped from Ohio bill
Car tag tax may be reduced
Vehicle tax can make or break political careers
East side road plans spur debate
Light-rail study called premature
Lost-baby case points to parents
Museum Center selects new director
Planner says vision for region catching on
Three DUI suspects have 10 priors among them
Workers get pizza instead of president
'Haggadah' book tied to 'Prince of Egypt'
Jimmy Carter faces aging with faith
Job loss, family death, auto accident test Crestview Hills couple
Learn about child safety while skating
Younger Harrelson making up for selfish years
Ban asked on reporters' testimony
Chabot leads drive to put TV cameras in federal courts
Chief given reprimand in 1995 Carlisle report details bad blood
Cleanup accepts tires, trash
Ex-UK player on DUI wreck: 'Scars will last forever'
HMO for low-income loses license
Mother, son sue over searches
Ousted mayor of Williamstown pleads guilty to bank robbery
School to shrink to limit expenses
Scramble for vets home
Sycamore planning new school
TRISTATE DIGEST
