New Jersey PBOR Becomes Law

August 1, 2001 (PLANSPONSOR.com) - On Monday New Jersey's acting governor, Donald T. DiFrancesco, signed a new patients' bill of rights into law.

The Health Care Carrier Accountability Act allows patients who believe that a health maintenance organization (HMO) decision has placed their lives or health in immediate danger to file suit in state court against the HMO. However, most people will still be required to make their case to a state-appointed medical panel before going to court.

The law provides an immediate right to sue in cases where the HMO’s decision risks:

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  • death
  • the loss of an organ or limb
  • serious or permanent impairment
  • worsening of a serious or life-threatening disease.

The New Jersey law does not limit damage awards, nor does it bar class actions. It does, however, shield employers and unions from lawsuits based on medical decisions made by health insurance companies.

However, nearly half of those with insurance in the state (2.7 million people) are covered by health plans regulated by the Employee Retirement Income Security Act (ERISA).

Although right-to-sue laws have been enacted in eight other states, they are all relatively new. Texas, the first to pass such a law in 1997, has seen just 20 lawsuits to date. The first was concluded recently ? in favor of the HMO (see HMO Books Victory in Texas Court ).

Connecticut State CIO Disputes Dismissal

January 7, 2001 (PLANSPONSOR.com) - Former chief investment officer Tom Flanigan last week lashed out at the state treasurer who had abruptly fired him on December 12, according to The Hartford Courant.

It was the latest episode in the continuing saga of the State of Connecticut pension fund.

State Treasurer Denise Nappier fired him because he was standing in the way of opportunities for Nappier’s ‘friends and contacts’ to make money by managing fund assets, Flanigan wrote in a letter to the Investment Advisory Council that monitors the Treasurer’s office. Flanigan did not name Nappier’s friends in the letter, which was cited in the newspaper.

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The State Treasurer’s office strongly denied the accusations. “These wild allegations about the treasurer acting on behalf of friends and contacts [are] unsubstantiated” and are “not found in any document or any exchange – other than the fantasies that this letter represents,” deputy treasurer Howard Rifkin told The Hartford Courant. He said Nappier would seek a retraction.

When Nappier fired Flanigan, she cited differences over his approach to “communications and administrative process” in managing the $22 billion state employee pension fund.

The public conflict lays bare the continued troubles of the Connecticut state fund, which Nappier and Flanigan were supposed to reform in the wake of the bribery-and-kickback scandal surrounding Nappier’s predecessor, Paul Silvester.

See also:

Corruption: Stamp out public fund piracy — before the damage is done

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