Edwards called the bill an “HMO Bill of Rights”, according to CongressDaily/A.M., and said the terms of the draft “appear to have multiple problems”, including:

• A provision that would allow states to opt out of having to adopt the federal patient protection standards if a governor could show that it would raise health care costs in the state by 2% or more
• A requirement that most new cases be tried in federal court, which Edwards said don’t have the resources to handle the cases

The Frist-Breaux bill would also let a state opt out if it could establish that:

• It has a state protection that is essentially the same or
• It has low HMO enrollment

In its current form, the Frist-Breaux bill ( Employers Might Find Patient Protection in Frist Bill ) would:

• Allow employers to designate a third party that will have “clear and exclusive” authority to make determinations that give rise to a cause of action
• Require patients to exhaust administrative appeals before going to court
• Bar punitive damages
• Limit non-economic damages to $500,000.

– Nevin Adams       editors@plansponsor.com