Government Relations
September 1999

The U.S. House of Representatives is preparing to vote on health plan legal accountability. This is the final opportunity to impact needed managed care reform legislation. Even if you have already called your Representative, please call him or her again during this crucial time as the bill prepares to come to the House floor during the week of October 4.

• If you are from a Republican district, call 800-852-6001, APA's legislative hotline, and enter your Zipcode to be connected to your Representative.
• If you are from a Democratic district, call the House Switchboard at (202) 225-3121.

When connected, please give the following message: "I'm calling as a psychologist and constituent to urge the Representative to vote for health plan legal accountability as contained in Representative Norwood's bill (H.R. 2723). Health plans must be held accountable when they deny or delay a promised benefit and the patient is harmed as a result. Also, it is important that the Representative support a "clean rule" which will allow a fair vote on managed care legislation."

Congress must include health plan legal accountability in its managed care reform bill. As a result of a loophole in a federal law called ERISA (Employee Retirement Income Security Act), most individuals and families enrolled in managed care plans are prohibited from bringing legal actions when they are injured as a result of negligent decisions by these plans to delay or deny treatment. The ERISA loophole allows plans to make negligent cost-containment decisions, including denials of covered benefits, without any accountability to the patient.

APA's efforts to close this loophole have begun to pay off. The House Republican Leadership hoped to pass legislation that did not grant patients the right to hold their health plan accountable when they are injured as a result of negligent decisions to delay or deny treatment. Instead, a group of Republicans, led by Representative Charlie Norwood, DDS (R-GA), have joined Democrats in support of a bipartisan compromise that includes this right. We need your Representative to support Norwood in his efforts to win inclusion of accountability and pass H.R. 2723.

During the Senate debate, psychologists mounted a significant grassroots effort that swayed key Republicans. Similar efforts on the House side could successfully move health plan legal accountability into the final negotiations.

If you have further questions, please contact David Nelson at the Practice Directorate's Government Relations Office at (202) 336-5870.