Patient’s Bill of Rights

Congress initiated a Patient’s Bill of Rights in 2001.  The Senate passed the Bill of Rights which included an enforcement portion, however the bill failed when it went to the House of Representatives. 

 

The Association of American Physicians and Surgeons adopted a list of ‘patient freedoms’ in 1990 which was modified and adopted as a ‘patients’ bill of rights’ in 1995.  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.

 

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