[House Document 107-42]
[From the U.S. Government Publishing Office]
107th Congress, 1st Session - - - - - - - - - - - - - House Document 107-42
PRINCIPLES FOR A BIPARTISAN PATIENTS' BILL OF RIGHTS
__________
COMMUNICATION
FROM
THE PRESIDENT OF THE UNITED STATES
TRANSMITTING
PRINCIPLES FOR A BIPARTISAN PATIENTS' BILL OF RIGHTS TO PROVIDE ALL
AMERICANS WITH PROTECTIONS IN MANAGED CARE
February 7, 2001.--Referred jointly to the Committees on Energy and
Commerce, Ways and Means, and Education and the Workforce and ordered
to be printed
The White House,
Washington, February 7, 2001.
Hon. J. Dennis Hastert,
Speaker of the House of Representatives,
Washington, DC.
Dear Mr. Speaker: I was grateful for the opportunity to
meet with you last month at the White House to discuss our
shared goal of passing a strong Patient's Bill of Rights. Over
the last two weeks my staff and I have met with Members of
Congress from both parties, and I believe that we have an
opportunity to work together to enact legislation this year to
address this important issue. I am writing to ask for your
support, and for the support of all Members of Congress, for a
bipartisan Patients' Bill of Rights to provide all Americans
with protections in managed care.
As Governor of Texas, I worked with Democrats and
Republicans to enact some of the strongest patient protection
laws in this country. My goal now in seeking Federal
legislation is simple: I want to ensure that all patients
receive needed medical care and that doctors are allowed to
make medical decisions.
To achieve these goals, patients should have the right to
an independent medical review of a health plan's decision to
deny care. This review should be conducted by medical experts
outside the health plan and must be binding on the health plan.
I also believe that, following an independent medical review of
a health plan's decision to deny care, patients who have been
wrongly denied medical care should be allowed to hold their
health plans liable in Federal court.
I cannot support a plan, however, that encourages
unnecessary or frivolous litigation. Expensive litigation, and
the resulting rise in health care costs, would only make it
more difficult for Americans to afford health care coverage in
the first place. I believe it is possible to provide patients a
meaningful remedy when they have been wrongly denied care,
without causing other Americans to lose coverage. A responsible
remedy for patients should protect employers from the high
costs of being subject to multiple causes of action in multiple
venues and should provide a reasonable cap on damages.
As you requested, I have enclosed the principles by which I
will gauge any piece of Federal legislation. I do not believe
that any bill currently before the Congress meets all of these
principles. However, I applaud the efforts of Members on both
sides of the aisle who have stepped forward to address this
issue. I believe we can work together to reach bipartisan
agreement this year on a strong Patient's Bill of Rights that
protects all Americans, does not override the patient
protections already adopted by states, and avoids costly
litigation.
I look forward to working with you and all Members of
Congress to enact these principles into law so soon as
possible. I also look forward to working with you to provide
access to health care for the millions of Americans without
health insurance.
Sincerely,
George Bush.
Principles for a Bipartisan Patients' Bill of Rights
Patient Protections Should Apply to All Americans
A federal Patients' Bill of Rights should ensure that every
person enrolled in a health plan enjoys strong patient
protections. Because many states have passed patient protection
laws that are appropriate for their states, deference should be
given to these state laws and to the traditional authority of
states to regulate health insurance.
Patient Protections Should be Comprehensive
A federal Patients' Bill of Rights should provide patient
protections such as: access to emergency room and specialty
care; direct access to obstetricians, gynecologists and
pediatricians; access to needed prescription drugs and approved
clinical trials; access to health plan information; a
prohibition of ``gag clauses''; consumer choice; and continuity
of care protections.
Patients Should Have a Rapid Medical Review Process for Denials of Care
Patients should have the right to appeal a health plan's
decision to deny care through both internal review and
independent, binding external review.
The Review Process Should Ensure that Doctors are Allowed to Make
Medical Decisions and Patients Receive care in a Timely Manner
Slow and costly litigation should be a last resort.
Patients should exhaust their appeals process first--allowing
independent medical experts to make medical decisions and
ensuring patients receive necessary medical care without the
expense or delay of going to court.
Federal Remedies Should Be Expanded to Hold Health Plans Accountable
After an independent review decision is rendered, patients
should be allowed to hold their health plans liable in federal
court if they have been wrongly denied needed medical care.
Patient Protection Legislation Should Encourage, Not Discourage,
Employers to Offer Health Care
Employers, many of whom are struggling to offer health
coverage to their employees, should be shielded from
unnecessary and frivolous lawsuits and should not be subject to
multiple lawsuits in state court. Increased litigation will
only result in higher health care costs, potentially forcing
employers to drop employee health coverage altogether. Only
employers who retain responsibility for and make final medical
decisions should be subject to suit.
Americans want meaningful remedies, not a windfall for
trial lawyers resulting in expensive health care premiums and
unaffordable health coverage. To protect patients' rights
without encouraging excessive litigation, damages should be
subject to reasonable caps.