More rights for patients, fewer for college students

In other key rulings, the court strengthened the hand of health-care patients, shielded colleges from lawsuits when giving out student records, and granted local authorities power to regulate tow-truck operators.

• In a 5-to-4 decision, the court ruled that states can help patients fight their health-maintenance organizations (HMOs), which could increase requests for second opinions. The court endorsed an effort, like those used in about 40 states, to let patients bypass health-plan gatekeepers who refuse to approve payment for a treatment.

The ruling takes pressure off Congress, which has failed to pass a national patients' rights plan. The state laws are intended to let people consult other doctors, and sometimes force HMOs to pay up if an independent review shows a surgery or other care is justified. The court said states, in trying to better arm patients, didn't conflict with federal law.

• In a 7-to-2 decision, the court barred students from using federal privacy laws to sue schools that divulge their personal information. The ruling sets up a firewall that protects schools and universities from costly court judgments for breaking the law that requires them to keep educational records secret. The justices sided with a college accused of leaking unproven date-rape accusations about a student. The court's ruling is a defeat for parents and privacy advocates who contend the law can be ignored with little consequences. The decision could affect lawsuits not just under the education privacy statute but many other laws that do not explicitly say violators can be sued.

• Also 7 to 2, the court decided that a 1994 federal law deregulating the trucking industry still gives city governments the power to regulate the safety of tow-truck companies. The ruling was a victory for the city of Columbus, Ohio, where tow-truck operators must obtain a license, maintain insurance, and abide by various safety and operating standards.