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S.283 THE BIPARTISAN PATIENT PROTECTION ACT OF 2001

The Bipartisan Patient Protection Act of 2001 was unveiled to the Senate on February 7 of this year. Co-sponsored by Sens. Edward M. Kennedy (D-MA) and John McCain (R-AZ), the bill is an attempt to break the five-year congressional stalemate on America's managed care reform. S. 283 attempts to secure a broad coverage of patient protection measures for those 161 million Americans with private health insurance. The legislation would:

· Force health insurers to properly inform patients about how the company plans are run;

· Require force HMOs to pay for significantly more out-of-network emergency care;

· Guarantee easier access to health care specialists; and

· Create an independent appeals panel through which disputes would be settled.

The legislation's most radical provision-the terms that most differentiate the bill from previous Patient Rights proposals--would allow patients to sue their health insurance providers for damages. More specifically, the bill gives patient's two methods through which to initiate litigation against their insurance companies:

1. MEDICAL JUDGEMENT: Patients thought to be injured or killed as a result of an insurance company's denied treatment, or medical judgment, would be permitted to sue in state courts. Caps on damages would be determined by individual state laws, which are often less restricting than those instituted by the federal government.

2. CONTRACTS: Otherwise, patients with disputes over covered benefits, or patients believing their HMO had violated terms of contract, would be forced to seek damages directly through the federal court system. The civil penalty has been limited to $5 million.

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