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June 30, 2000

WEEKLY UPDATE for June 30, 2000

***LEGISLATIVE UPDATE
Patient Protections- Latest Senate Action
H.R. 1304, "The Quality Health Care Coalition Act of 1999"
Violence Against Women Act Reauthorization Bill, H.R. 1248

THE PATIENTS' BILL OF RIGHTS- Latest Senate Action

The clash over patient's rights continues in Congress. On Thursday night the Senate by a vote 51-47 adopted a Nickles amendment to the Labor-HHS Appropriations bill. The amendment, essentially the text of a comprehensive bill Senate Republicans developed over the past few weeks, would offer patients a limited right to sue HMOs. It falls far short in covering all insured Americans and in fact the Senate rejected a Dorgan/Kennedy amendment that would have expanded the measure's scope to cover all insured Americans. ACEP members should note that the GOP proposal does not reflect the patients' bill of rights conference agreement language (as reported in the press).

In terms of emergency services, the Senate amendment does not include the very important phrase that the "plan must pay in a manner such that a patient would not be liable for any additional payments than if the provider was a participating provider." This language, included in the conceptual agreement reached by conferees on H.R. 2990, places the responsibility on the plan to pay the balance of any payments due to the provider. In the Senate amendment passed last night this phrase was omitted. The amendment also reduces the time limit for plans to respond to a physician's call seeking to coordinate post-stablization care from 3 to 2 hours.

The vote for the amendment was along party lines with the following exceptions: Republican Senators voting against the amendment were Chafee (RI); Fitzgerald (IL), Spector (PA), and McCain (AZ). The Dorgan/Kennedy (Democratic amendment) was defeated by the same margin with the same Republican members breaking ranks.

The vote was yet another exercise in futility since House Republicans reacted angrily to its provisions and its inclusion in an appropriations bill. Their reaction, coupled with unanimous Democratic opposition in the Senate and House leaves little doubt about its future. Moreover, President Clinton has already stated that he would veto the measure.

The good news is that the four Republicans who had previously voted for a strong patients' rights maintained their unity. In addition, Sen. Nickles' (R-OK) maneuver further angered House Republicans and smoked out actual legislative language, which should be helpful in picking up the additional vote we need in the Senate.

Earlier in the day, Rep. Charles Norwood (R-GA), sponsor of the House-passed bill, appeared with 20 other House Republicans at a press conference to warn the Senate against passage of a scaled-down managed care legislation. "The bill approved by the Senate tonight with nothing but Republican votes proves once again that a partisan bill cannot become law. This monstrosity is dead on arrival in the House," Norwood said.

House leaders need our help in making the public aware of the Senate bill's failure to cover most Americans along with the bill's other flaws. We will be discussing the best ways to do that in our next 911 update.

CAMPBELL BILL (H.R. 1304) PASSES THE HOUSE BY A VOTE OF 276 - 136
GUTTING AMENDMENTS FAIL - COBURN ABORTION AMENDMENT PASSES

H.R. 1304, "The Quality Health Care Coalition Act of 1999" sponsored by Reps. Tom Campbell (R-CA) and John Conyers (D-MI), passed the House of Representatives early this morning by a vote of 276-136. The legislation would allow physicians and other health care providers to collectively bargain with health plans.

Six amendments to the legislation were also considered. The House rejected several amendments aimed at weakening the bill, such as a provision that would have barred negotiations between doctors and health plans related to fees. It did adopt, by a vote of 213-202, an amendment by Rep. Tom Coburn (R-OK) that would bar health care professionals from negotiating with health plans about restrictions on abortion services. Another amendment sponsored by Danny Davis (D-IL), which expresses the sense of the Congress that medical decisions regarding treatment should be made by the physician or health care professional and the patient, passed by a voice vote.

The Senate does not have a companion bill. Rep. Campbell and ACEP, in conjunction with other physician specialty organizations and the AMA, have been working to identify potential sponsors. However, given the limited time left before Congress adjourns, it is questionable whether the Senate will take action on this legislation.

Thanks to everyone who contacted his/her member of Congress for this crucial vote. We will keep you updated on any developments.

See How Your Representative Voted On: Final Passage and/or the following amendments (to see the results, click on the "Roll No." link after the description of the amendment): Ballenger Amendment, Stearns Amendment; Cox Amendment; Terry Amendment; Coburn Amendment; Davis Amendment.

Violence Against Women Act Reauthorization Bill, H.R.1248
Mark-ups Completed in Both House and Senate

The House mark up of the VAWA Reauthorization Bill, H.R. 1248, was completed on Tuesday afternoon. The bill will be sent to the floor for consideration by the full House soon after the July 4 recess. On the Senate side, the Biden-Hatch VAWA Reauthorization bill (S. 2787) was introduced in the Senate on June 26th and was marked up on, June 29th. The bill passed through committee without amendment but has not yet been scheduled for a Senate vote. The text of the bill should be available on the Congressional website http://thomas.loc.gov in the next few days.