Re: *IMPORTANT* Call for informatioon...

Re: *IMPORTANT* Call for informatioon...

Ted A. Trower

3/12/1998

For those of use who have been ripped off by self-insured corporations the
lack of any laws or regulations in this area is pretty infuriating. I
picked this up off of the homecare listserv that I've been monitoring. We
may want to get involved here!

The balance of this message is copied from the homecare list.:

Ted

----------------------


The plans which ensure private employees are governed by ERISA. The details
of ERISA are pretty arcane, but the bottom line is that plans get to do all
sorts of outrageous things with the benefits because the law has stripped
the patients of any real legal recourse.

In the meantime, here's where your leverage is:

Several of the plans you described look as though they insure public
employees who, by definition, are not subject to ERISA. Look for egregious
cases and see what might be done (I'm not a New York lawyer) to have the
patients sue the carriers for bad faith breach of the insurance agreement.
The carriers will have to either:

(a) Dig in and face major losses when the suits come;

(b) Retain more liberal benefits for public employees who they insure,
but risk looking absolutely horrible in the media when they insist on more
stingy benefits for ERISA-restricted private employees they insure; or

(c) Make some rational across the board accommodation that will protect
patients' rights.

Good luck!



(Congressman Charles Norwood has a bill, PARCA, with over two hundred
co-sponsors, and your patients should be contacting his office and enlisting
in the fight.)

You can reach Cong. Norwood via www.house.gov/norwood.


                     Washington office: 1707 Longworth HOB
                                                Washington, DC 20515
                     Phone # 202 225 4101
                     Fax # 202 225 0279




     H.R.1415 (Norwood) PARCA (4/22/97)

          212 cosponsors as of 12/31/97
          D'Amato is the Senate sponsor of S.644

You might also check out the 'Dialog' listserv at < <Email Address Redacted> >. HARP
is the Health Administration Responsibility Project, a voluntary
organization of physicians and other health care professionals who are fed
up with HMO atrocities and are fighting back on legislative and legal
fronts. Plenty of resources on their web page, and a really interesting
list serv.

You get what you settle for. Thelma and Louise




                                                Mark Allen Kleiman