SUPREME COURT CASE PROVIDES CLEAR EXAMPLE OF WHY CONGRESS MUST ENACT A PATIENTS' BILL OF RIGHTS

The following is a statement by Ron Pollack, executive director of Families USA, concerning the case before the U.S. Supreme Court today challenging a patient's right to appeal HMOs' denials of health care to an independent, administrative review board:

"The case before the Supreme Court demonstrates, once again, the incredible contradictions of the managed care industry when it comes to patients' rights. During the patients' bill of rights debate in Congress, the industry fought vigorously to block legislation that would establish a patient's right to sue an HMO. The industry said that, instead of bringing lawsuits, consumers should seek relief from independent, administrative review boards.

"Currently, 37 states and the District of Columbia have established such independent, administrative review boards. But, as today's Supreme Court argument makes painfully clear, some of the largest companies in the managed care industry are challenging the validity of the state laws that created these independent, administrative review boards. In so doing, the managed care industry gives 'duplicity' a bad name.

"The managed care companies involved in this and related litigation now say that patients' only recourse - in the face of improper denials of needed health care - should be so-called 'internal hearings' run by, and decided by, HMO bureaucrats. In effect, the managed care industry wants consumer disputes to be handled in such a way that the HMO is the judge, prosecutor, and jury.

"This is a perfect example of why this country can't afford to wait any longer for a strong patients' bill of rights. Congress should pass legislation this year that will allow patients to hold their HMOs accountable through independent review boards and will allow patients to sue such plans for the damages they cause."

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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.

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