The Senate debate on what has come to be known as the "Patients' Bill of Rights" is the focus of this week¹s In the News. The call for legislation of this type has garnered increased attention and support over the past two years as complaints have mounted over the often unappealable decisions of HMOs to deny coverage or restrict access. While both Democrats and Republicans favor such legislation, there are key differences between the two parties' approaches. Republicans have offered a bill that establishes an independent medical reviewer for insured patients denied coverage, while Democrats favor giving patients expanded litigation options as a way to discipline HMOs. Democrats also want to see legislation that returns the ultimate decision on medical treatment to the patient's physician. Republicans disagree with this approach, seeing it as a return to the cost problems that generated the widespread need for HMOs originally. Finally, the Republican version of this legislation promises full protection only to Federal employees as GOP legislators argue the states already protect private employees.