By Amy Goldstein
Washington Post Staff Writer
Wednesday, July 15, 1998; Page A07

Senate Republican leaders plan this morning to unveil their version of legislation to strengthen the government's regulation of managed health care, as political jockeying intensifies in an effort to seize control of the popular issue of "patients' rights."

The senators plan to call for protections to make it easier for people to get emergency room bills paid, ensure that doctors can discuss expensive treatments with their patients, and create stronger avenues of appeal when patients are denied care they think they deserve, sources familiar with the group's work said last night.

The emergence of the Senate GOP leadership bill sets the stage for the final battle this year over a new generation of federal health reform. Moving with unusual speed, Majority Leader Trent Lott (R-Miss.) plans to bring the bill directly to the floor, bypassing the normal review in committee, and said debate could begin as early as the start of next week.

Last November, President Clinton called on Congress to adopt a "patients' bill of rights" to shift the balance of power away from managed-care plans, now dominating the nation's health care system, which seek to control costs by effectively limiting how much and what kind of care patients may receive.

Republicans initially were divided on the issue, with the leadership in both houses deriding the idea as government intrusion. But the issue has proved remarkably popular with voters and is sparking an election-year contest among Democrats and rival factions of Republicans eager to win credit for protecting their constituents' interests.

In its broad outlines, the Senate measure to be disclosed today, drafted by eight senators led by Majority Whip Don Nickles (R-Okla.), resembles a "patients' rights" bill produced by the House GOP leaders three weeks ago. Like the House version, the bill omits any effort to broaden patients' ability to sue their health plans for malpractice, a particularly contentious idea favored by consumer groups but strongly opposed by the insurance industry.

But the two GOP leadership measures differ in significant details.

Unlike the House version, the Senate measure will not include two controversial provisions intended to make it easier for small businesses to afford health insurance. On the other hand, it includes language -- not found in the House bill -- that would prohibit insurance companies from using family history of disease or genetic tests in deciding how much to charge a patient for coverage.

And while the details were unclear, the Senate version also may attempt to direct insurers to allow women with breast cancer to remain hospitalized for a specified period of time following mastectomies, a favorite cause of Sen. Alfonse M. D'Amato (R-N.Y.).

The bill also would make it easier for patients to see and get copies of their medical records, although it may include less detailed protections of the confidentiality of those records than similar bills. And it would promise some patients access to "point-of-service" plans that permit more choice of physicians than traditional health maintenance organizations.