PATIENTS’ RIGHTS: GOP Unveils HMO Reform Bill
Senate Republicans Friday introduced their Patients' Bill of Rights, CongressDaily reported. Crafted by the GOP Conference's health care task force, the bill "is essentially the same bill as offered last Congress, minus portions related to women's health care that were reauthorized last year as part of the omnibus spending bill." Aides to Senate Majority Whip Don Nickles (R-OK) said most of the new portions of the measure would "apply only to businesses that insure themselves for health care, and therefore are not already regulated by the states." The new external appeals process directed under the bill, however, would apply to both state- and self-regulated plans. "On the tax front," the measure would raise the cap placed on medical savings accounts, allow self-insured individuals to deduct 100% of their health insurance and permit up to $500 in a flexible spending account to be carried over to the next year. In addition, the measure would require self-insured plans to:
- Use the "prudent layperson" standard for providing "initial emergency screening exams";
- Provide point-of-service coverage;
- Provide direct access for women to OB/GYNs and children to pediatricians;
- Ban "gag rules";
- Provide members with a "wide range of comparative information";
- Establish internal and external appeals processes;
- Allow patients to "inspect and copy" their medical records;
- Disclose "confidentiality practices" and institute "safeguards for patient information";
- Not deny coverage or adjust premiums based on genetic information (Morrissey, 1/22).