- The Washington Times - Wednesday, August 1, 2001

House backers of a patients' rights bill, similar to a Democratic-endorsed measure passed by the Senate, appear to have reached an agreement with the White House, setting up a House vote tomorrow.
President Bush yesterday signaled confidence an agreement could be reached on the bill he previously threatened to veto.
"We don't have a specific deal yet but we're making progress," Mr. Bush told reporters in the Oval Office. The president has said patients' rights legislation could open the floodgates to lawsuits that would drive up costs and force employers to cancel or reduce coverage for their workers.
Mr. Bush's comment followed administration talks with Rep. Charlie Norwood, Georgia Republican, who is negotiating on behalf of legislation written jointly by Reps. Greg Ganske, Iowa Republican, and John D. Dingell, Michigan Democrat.
Rep. Ernie Fletcher, Kentucky Republican and author of a rival House GOP leadership bill, said he expects the Ganske-Dingell bill to be the "base bill" for amendment.
The major focus of amendments will be to reduce a $5 million limit on punitive damages for medical injury under the Ganske-Dingell bill and "reducing frivolous lawsuits," Mr. Fletcher, a family physician, said at a news conference with small business owners.
Many business owners fear increased lawsuits against employers under federal patient-protection legislation.
The Fletcher bill has a $500,000 cap on punitive damages for medical injury. White House spokesman Ari Fleischer has said Mr. Bush would accept a $750,000 cap, which is the limit for punitive damages under a Texas state patients' protection statute.
Barring a breakdown in negotiations that continued last night, the House Rules Committee is expected to meet today to establish rules for House debate and amendments to the bill, and a likely vote on the House floor tomorrow.
In a personal telephone conversation on Monday, Mr. Bush pressed Mr. Norwood "quite hard" to side with the GOP-backed approach under the Fletcher bill, said aides familiar with the conversation.
But Mr. Norwood told the president he was committed to a bipartisan approach to a patients' rights bill and wanted to negotiate changes acceptable to all sides, the sources said on the condition of anonymity.
The bill is virtually identical to a Senate-passed measure authored by Sen. John McCain, Arizona Republican, and Democratic Sens. Edward M. Kennedy of Massachusetts and John Edwards of North Carolina.
Yesterday, negotiations focused on a change to include under the bill's liability exemption provisions for large companies with self-financed and self-administered employee health plans, used by companies such as Wal-Mart, 3M and Caterpillar. About 6 percent of employers and 6 million to 10 million workers are covered by such plans.
The large companies were omitted from a Senate-adopted amendment because lawmakers said they could not word the statute adequately.
The provision permits employers to name a "dedicated decision maker" for medical coverage decisions — a health maintenance organization, insurance company or third-party administrator — to shield employers from lawsuits for medical injury under the law. An employer could not be sued unless listed as dedicated decision maker in the health plan contract.
Mr. Ganske said the "dedicated decision maker" provision satisfied White House negotiators and business groups. "We think this could effectively seal the deal, and we could have a nice bipartisan vote and go home for August recess, and the administration can move on to other issues in the fall," he told reporters.
Mr. Fletcher's bill may be allowed as a substitute or "offered in pieces" to try to amend the Ganske-Dingell bill, said John Stone, Mr. Norwood's spokesman.
Mr. Fletcher said his bill permits lawsuits in federal court only if internal and independent reviews of medical injury have been exhausted. Otherwise, lawsuits would go to state courts with no caps or limits on punitive damages for medical injury, he said.
The Ganske bill would permit lawsuits against employers only in federal court and only after the external independent medical review process has been completed, Mr. Stone said.
After a struggle of several years, lawmakers have relatively little disagreement over the protections to be offered to patients in the legislation. All individuals with insurance would receive new protections, such as the right to emergency room care, access to specialists, minimum hospital stays for mastectomies and access to government-run clinical trials.
This article is based in part on wire service reports.

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