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July 24, 2006 at 12:56 PM
America’s Health Insurance Plans is battling the American Trial Lawyers Association and the National Conference of State Legislatures over access to patients’ lawsuit settlements.
Lawmakers serving on a House-Senate conference committee are deciding whether to include a settlement measure, a “subrogation” provision, as they work to meld H.R. 2830 and S. 1783, the House and Senate pension bills.
Section 307 of H.R. 2830 would create a new federal cause of action under the Employee Retirement Income Security Act, allowing group health insurers to sue injured plan members who receive settlements from the parties that cause the injuries. Insurers would stand first in line when seeking reimbursement for expenditures from settlement funds. The provision could reduce the amount of cash that the plan members and their lawyers would receive.
The House provision would replace the current mixture of state statutes, federal statutes and court decisions that now govern group health plan subrogation actions.
Rep. John Boehner, R-Ohio, the House majority leader, is one of the pension bill conference committee members who support the provision.
Sen. Edward Kennedy, D-Mass., another conference committee member, said last week that removing the subrogation provision from the final pension bill is a priority.
Keeping the House H.R. 2830 subrogation provision would let insurers take money that was intended to cover injured patients’ future medical expenses and to compensate the patients for lost wages, Kennedy said in June.
Implementing the provision would have “devastating consequences for people who suffer serious and often permanent injuries, such as paralysis or loss of cognitive function,” Kennedy said.
