Patients' rights already exist in some states, health-care plans.(Knight Ridder Newspapers)

WASHINGTON _ During the six years that Congress has been considering a so-called patients' bill of rights, large health-care plans and state lawmakers have adopted many of its proposals.

With one big exception _ the rules under which patients can sue insurers _ many people won't notice much difference in their care and coverage if the bill becomes law.

Even patients' rights advocates acknowledge that the managed-care industry has become more responsive.

Most large HMOs, for example, now cover more medical procedures and services, such as emergency room care, access to specialists and a guaranteed minimum number of days for hospital stays, ...