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HMOs like House Republicans' reform plan

The plan does not allow Floridians to sue an HMO for damages when it improperly denies medical care.


© St. Petersburg Times, published April 7, 2000

TALLAHASSEE -- With polls showing that HMO reform is likely to play well in the November elections, House Republicans on Thursday unveiled their "Patient Protection Act of 2000."

House Speaker John Thrasher said the measures would guarantee that "doctors again will be making the final decision." Gov. Jeb Bush endorsed the plan, saying it would "guarantee Florida's citizens the higher level of patient protection and quality care they so rightly deserve."

And it won praise from another quarter, too: the HMO industry it intends to regulate. The proposal contains several controversial measures pushed by various health and insurance lobbyists.

House lawmakers said the proposal would ensure that HMO employees who decide whether medical services should be covered will be doctors.

But the plan does not allow Floridians to sue an HMO for damages when it improperly denies medical care, something that a bipartisan group of lawmakers in the Senate is considering.

The House proposal closely mirrors a plan drawn up by Associated Industries of Florida, the state's most powerful business lobby and an opponent of most proposals to crack down on the managed care industry.

"They left out a few of our ideas, but we think it's a good bill," said Associated Industries' lobbyist Jodi Chase. Republicans in the Senate who support allowing residents to sue HMOs for damages had less flattering things to say.

"I haven't seen it yet, but I suspect its pretty much in line with what the industry wants, so how meaningful can the reform be?" asked Senate Majority Leader Jack Latvala, R-Palm Harbor. Democrats branded the plan the "HMO protection act." Noting that Bush did not mention HMO reform in his speech outlining his priorities for the 2000 legislative session, Rep. Debbie Wasserman Schultz of Weston said the plan "was rolled out today to provide the Republicans with cover" in the upcoming November elections.

"In the Senate, at least we're having discussions," said Sen. Ron Klein, D-Boca Raton. "This is legislation for an industry, by an industry."

Details of the House Republican plan were not available: An actual bill will be filed next week. But as outlined, the plan is aimed at encouraging HMO consumers to rely on rights they already have.

A state panel to which consumers can appeal when care is denied would have to take action more quickly. Doctors and hospitals would be required to post the state's three toll-free numbers for consumer complaints. Rep. Tom Feeney, an Oviedo Republican who is in line to become the next House speaker, said he hopes such measures will comfort people.

"A lot of people I talk to are terrified they won't get access to a doctor when they need it," he said.

The plan proposes studying the alarming rate of medical mistakes, but lawmakers did not endorse a proposal that would make those mistakes more readily available to the public.

The Patient Protection Act of 2000 also proposes several things that have little to do with patient protection.

The House plan would re-evaluate health care benefits the state now forces insurers to provide. Businesses say the mandates make insurance more expensive. Proponents say they protect patients from a managed health care system in which insurers boost their bottom line by refusing to cover reasonable treatments.

The plan would give hospitals that provide indigent care a $40-million tax break. Hospitals currently pay the tax to help support the state's Medicaid program for the poor. It would also loosen state regulations governing where medical facilities may be built and what services they can provide.

The Patient's Rights Coalition, which wants the right to sue HMOs, pointed Thursday to hefty campaign contributions to the Republican Party as the reason "meaningful" HMO reform is being stymied.

But Feeney said lawsuits only increase insurance costs as well as the rolls of Florida's uninsured.

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