U.S. Patients' Bill of Rights

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A Patient's Bill of Rights is a statement of the rights to which patients are entitled as recipients of medical care. Typically, a statement articulates the positive rights which doctors and hospitals ought to provide patients, thereby providing information, offering fair treatment, and granting them autonomy over medical decisions.

Contents 1 Consumer Bill of Rights and Responsibilities 2 McCain-Edwards-Kennedy Patients' Bill of Rights Senate bill S.1052 3 Others 4 See also 5 References

[edit] Consumer Bill of Rights and Responsibilities

The following summarizes eight areas of consumer rights and responsibilities adopted by the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry in 1998 [1]. Many health plans have adopted these principles:

1. Information Disclosure. Consumers have the right to receive accurate, easily understood information and some require assistance in making informed health care decisions about their health plans, professionals, and facilities.
2. Choice of Providers and Plans. Consumers have the right to a choice of health care providers that is sufficient to ensure access to appropriate high-quality health care.
3. Access to Emergency Services. Consumers have the right to access emergency health care services when and where the need arises. Health plans should provide payment when a consumer presents to an emergency department with acute symptoms of sufficient severity -- including severe pain -- such that a "prudent layperson" could reasonably expect the absence of medical attention to result in placing that consumer's health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.
4. Participation in Treatment Decisions. Consumers have the right and responsibility to fully participate in all decisions related to their health care. Consumers who are unable to fully participate in treatment decisions have the right to be represented by parents, guardians, family members, or other conservators.
5. Respect and Nondiscrimination. Consumers have the right to considerate, respectful care from all members of the health care system at all times and under all circumstances. An environment of mutual respect is essential to maintain a quality health care system.
6. Confidentiality of Health Information. Consumers have the right to communicate with health care providers in confidence and to have the confidentiality of their individually identifiable health care information protected. Consumers also have the right to review and copy their own medical records and request amendments to their records.
7. Complaints and Appeals. All consumers have the right to a fair and efficient process for resolving differences with their health plans, health care providers, and the institutions that serve them, including a rigorous system of internal review and an independent system of external review.
8. Consumer Responsibilities. In a health care system that protects consumers' rights, it is reasonable to expect and encourage consumers to assume reasonable responsibilities. Greater individual involvement by consumers in their care increases the likelihood of achieving the best outcomes and helps support a quality improvement, cost-conscious environment.

[edit] McCain-Edwards-Kennedy Patients' Bill of Rights Senate bill S.1052

The McCain-Edwards-Kennedy Patients' Bill of Rights Senate bill S.1052 was an attempt to providing comprehensive protections to all Americans in health plans in 2001.

The House of Representatives and Senate passed differing versions of the Patients' Bill of Rights. Although both bills would provide patients key rights such as prompt access to emergency care and medical specialists, only the Senate-passed measure would provide patients with adequate means to enforce their rights.

The Senate-passed Patients' Bill of Rights confers a broad array of rights on patients. The bill would ensure that patients have the right to:

• have their medical decisions made by a doctor;
• see a medical specialist;
• go to the closest emergency room;
• designate a pediatrician as a primary care doctor for their children;
• keep the same doctor throughout their medical treatment;
• obtain the prescription drugs their doctor prescribes;
• access a fair and independent appeals process if care is denied; and
• hold their health plan accountable for harm done.

The Congress did not pass this bill in 2002.

[edit] Others

Some have cited differences between rights and freedoms. Asserting that medical care "must be rendered under conditions that are acceptable to both patient and physician", the Association of American Physicians and Surgeons adopted a list of Patient Freedoms in 1990 [2] which was modified and adopted as a Patients' Bill of Rights in 1995 [3]:

All patients should be guaranteed the following freedoms:

• To seek consultation with the physician(s) of their choice;
• To contract with their physician(s) on mutually agreeable terms;
• To be treated confidentially, with access to their records limited to those involved in their care or designated by the patient;
• To use their own resources to purchase the care of their choice;
• To refuse medical treatment even if it is recommended by their physician(s);
• To be informed about their medical condition, the risks and benefits of treatment and appropriate alternatives;
• To refuse third-party interference in their medical care, and to be confident that their actions in seeking or declining medical care will not result in third-party-imposed penalties for patients or physicians;
• To receive full disclosure of their insurance plan in plain language, including:

1. CONTRACTS: A copy of the contract between the physician and health care plan, and between the patient or employer and the plan;
2. INCENTIVES: Whether participating physicians are offered financial incentives to reduce treatment or ration care;
3. COST: The full cost of the plan, including copayments, coinsurance, and deductibles;
4. COVERAGE: Benefits covered and excluded, including availability and location of 24-hour emergency care;
5. QUALIFICATIONS: A roster and qualifications of participating physicians;
6. APPROVAL PROCEDURES: Authorization procedures for services, whether doctors need approval of a committee or any other individual, and who decides what is medically necessary;
7. REFERRALS: Procedures for consulting a specialist, and who must authorize the referral;
8. APPEALS: Grievance procedures for claim or treatment denials;
9. GAG RULE: Whether physicians are subject to a gag rule, preventing criticism of the plan.

[edit] See also

• Health care reform in the United States
• Patient empowerment
• Pregnant patients' rights

[edit] References

• Summary of the McCain-Edwards-Kennedy Patients' Bill of Rights S.1052 2001. from the Senate Democratic Caucus.
• Consumer Patient Rights and Responsibilities Advisory Commission on Consumer Protection and Quality in the Health Care Industry