Bush and the Republican leaders say they will try to reach a compromise with some of the supporters of H.R. 2563.
The primary difference between the two bills involves the liability regimes.
H.R. 2315 would require patients to try to resolve all coverage disputes through an independent review.
Patients could file lawsuits in state courts against their health plans for adverse coverage decisions only if the plan refuses to implement the independent review panels decision.
In addition, patients could sue their plans in federal courts for undue delays in making coverage decisions. However, non-economic damages would be capped at $500,000.
By contrast, H.R. 2563, which is identical to legislation recently passed by the Senate, would allow patients to file lawsuits in state courts against health plans and plan sponsors for adverse coverage decisions without waiting for an independent review.
In addition, health plans could be sued in federal court for administrative lapses and face fines of up to $5 million.
Reproduced from National Underwriter Life & Health/Financial Services Edition, August 6, 2001. Copyright 2001 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.
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