Families USA Executive Director Says HMO Decision Shows Need for Patients' Bill of Rights

The following statement by Ron Pollack, Executive Director of Families USA, was made in reaction to the Supreme Court's ruling today in Pegram v. Herdrich - a decision holding that HMOs are shielded from litigation under the federal ERISA statute:

"The Supreme Court's decision is a very timely reminder that we need federal patients' rights legislation. The Court's ruling underscores the fact that consumers can do little to hold their health plans accountable for decisions that wrongfully deny or delay needed care. Even when consumers are denied essential care due to improper financial considerations, HMOs are shielded from liability for the harm they cause.

"If this had been a doctor, a nurse or a hospital, the patient, Cynthia Herdrich, would have been able to sue, but HMOs - which are increasingly taking decision-making out of the hands of our doctors and nurses - can escape responsibility for the harms they cause. As the Supreme Court recognized, however, Congress can correct this problem through a change in the federal ERISA statute.

"By an overwhelming bi-partisan (275 to 151) vote last October, the House of Representatives has taken us down the road towards correcting this problem. The House-passed Patients' Bill of Rights would enable consumers to sue their HMOs in state courts whenever those HMOs improperly deny or delay care. It is now up to the Senate Republican leadership to include this needed provision in patients' rights legislation currently pending in a House-Senate Conference Committee."

Families USA is the national organization for health care consumers. Ron Pollack was the only consumer organizational representative on the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry - the Commission that first proposed a Patients' Bill of Rights in 1997.

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Families USA is the national organization for health care consumers. It is nonprofit and nonpartisan and advocates for high-quality, affordable health care for all Americans.

1201 New York Avenue NW, Suite 1100 · Washington, DC 20005
202-628-3030 · E-mail: info@familiesusa.org · www.familiesusa.org