AIDS advocates back democratic HMO reform bill

AIDS advocates back democratic HMO reform bill

The Washington Blade - August 13, 1999
Kai Wright

As Congress wades through a second session of contentious, partisan debate on how to reform managed care, AIDS policy advocates are once again supporting the Democratic version of what both parties have dubbed the "patient's bill of rights."

The Senate passed the Republican bill on July 15, by a 53 to 47 vote. The primary differences for people with HIV and AIDS between that bill and the measure pushed by Sen. Edward Kennedy (D-Mass.) involved a patient's ability to sue his or her HMO, a patient's right to use a specialist as a primary care provider, access to greater varieties of prescription drugs, and coverage for participation in clinical trials. The Democratic proposal offered each of these rights, while the Republican bill offered none of them.

Another critical dispute in Hill debates on the issue have been whether the physician or the HMO holds the final authority in determining what treatments are "medical necessities." The Democratic version gave the final say in that decision to individual doctors, the GOP version left the power to define a medical necessity with the HMO.

Jeff Crowley, deputy director of the National Association for People With AIDS, said the same divisions will exist between the House Democratic and Republican versions. The House has not begun floor debate on HMO reform and it was unclear this week whether or not they would take up the sticky issue before going on recess in early August.
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Always watch for outdated information. This article first appeared in 1999. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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