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                                                           Calendar No. 160
                    106TH CONGRESS              S                        REPORT
                       1st Session              SENATE                    106-82





                              PATIENTS' BILL OF RIGHTS ACT OF 1999



                                     JUNE 17, 1999.-Ordered to be printed.



                     Mr. JEFFORDS, from the Committee on Health, Education, Labor,
                                  and Pensions, submitted the following


                                              REPORT

                                              together with

                       ADDITIONAL, MINORITY, AND SUPPLEMENTAL VIEWS

                                            [To accompany S. 3261
                      The Committee on Health, Education, Labor, and Pensions, to
                    which was referred the bill (S. 326) to improve the access and
                    choice of patients to quality, affordable health care, having consid-
                    ered the same, reports favorably thereon with an amendment in
                    the nature of a substitute and recommends that the bill do pass.
                                                CONTENTS
                                                                                  Page
                      I. Purpose  and  summary  of the  legislation  .....................................................  1
                      II. Background  and  need  for the  legislation  .....................................................  5
                      III. Legislative  history  and  votes in  committee  .................................................  16
                      IV. Explanation of the legislation and committee views .................................. 28
                      V .  C ost  estim ate  ................................................................................................. .  57
                      VI. Application  of law  to  the  legislative branch  ...............................................  62
                    VII. Regulatory  im pact  statem ent  ........................................................................  62
                    V III.  Section-by-section  analysis  ............................................................................  63
                    IX . A ddition al  view s  .............................................................................................  96
                      X .  M in ority  view s  ...............................................................................................  100
                      X I.  Supplem ental  view s  .......................................................................................  109
                      IX .  Changes  in  existing  law   ................................................................................  110

                              I. PURPOSE AND SUMMARY OF THE LEGISLATION
                      Purpose. The Employee Retirement Income Security Act (ERISA)
                    of 1974 governs pension plans and employee welfare benefit plans,
                    including group health plans. For group health plans, it contains
                       57-401