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Health Care Reform:

Health Insurance & Affordable Care Act

WebMD Health News

HMOs Say Recent Medical Errors Report Backs Argument Against 'Patient Protection' Bill

Jan. 6, 2000 (Washington) -- Foreshadowing a bruising congressional battle over managed care regulation, HMOs are claiming that a recent national report on medical errors equips their argument against the current "patient protection" legislation. Instead, they suggest that Congress take a much broader look at the medical establishment in the upcoming debate over the patients' bill of rights.

At the industry's kickoff press conference for the year, Karen Ignagni, president of the American Association of Health Plans (AAHP), a managed care trade organization representing many of the nation's major HMOs, emphasized that the "[medical errors report] should expand the discussion about what constitutes true patient protection."

Last November, the Institute of Medicine (IOM) made national headlines by reporting that preventable medical errors are the nation's 8th leading cause of death. With this in mind, Ignagni says, "The entire [patient protection] debate has missed the mark." Up until now, the debate has focused on protecting patients from the health plans themselves. But the HMOs may not be the only bad guys; the IOM report suggests that patients likely need to be shielded from the entire medical establishment.

The hotly contested patients' bill of rights passed by the House last October focused almost solely on measures affecting the health insurance industry. The bill grants patients the right to sue their health insurance companies in state courts. It also requires that HMOs establish external, independent medical review boards for disputed care issues. Plans would pay the costs of reviews, and panel decisions would be binding. Under the bill, a patient could still sue an HMO if a board ruled against them, but that suit would go to federal court.

The recent IOM report, however, offers health plans a higher-road tack against this legislation. One of health plans' main arguments against the bill has been cost concerns. Ignagni claimed, for example, that enactment of the bill passed by the House would force companies to reconsider whether they will offer employee health coverage.

But the AAHP faces a tough challenge, as the American Medical Association has pegged final passage of the House bill as its top Washington priority for the coming year.

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