For Immediate Release Contact: Jim Farrell or Andy McDonald
March 18, 1999
For Immediate Release
Contact: Jim Farrell or Andy McDonald
Senate Committee Considering Legislation This Week
Offers Physician Choice, Health Care Ombudsman, Patient Advocacy Protection, Other Amendments
Says Republican bill, in present form, is "woefully inadequate"
(Washington, D.C.) -- Echoing the concerns of
Minnesotans about the need to improve the nation's health care system, Senator
Paul Wellstone renewed his call today for passage of a strong Patients' Bill of
Rights this year at a Senate Committee meeting where the legislation is being
considered. He offered several amendments to improve the existing bill, which he
called, in its present form, "woefully inadequate." Enacting a Patients' Bill of
Rights has been a priority for Wellstone since 1994, when he introduced the
first Patient Protection Act. The measure is being debated in the Senate Health,
Education, Labor and Pensions (HELP) Committee, of which Wellstone is a
"Five years ago I introduced a patient protection bill
because I was already hearing the stories from Minnesotans of necessary care
delayed and denied," Wellstone said. "These concerns about managed care are
heard louder than ever today. Patients and caregivers should be protected
against bottom-line medicine. Our system should be about managed care rather
than "managed cost." I believe that everyone in America has the right to
quality, affordable and comprehensive health care coverage. Patients shouldn't
have to fight with their insurance companies over every bit of coverage."
"The Republican version of this bill, being debated this
week, is woefully inadequate and a half-hearted attempt at enacting patient
protections," Wellstone said. "This bill in its current form is weak, and
does not go nearly far enough. I will work hard to make sure we pass a bill that
addresses the real needs of patients in our system."
Wellstone's "Point of Service" Amendment guarantees
patients the choice to stay with or go to a particular doctor not included in a
plan's network of providers. If patients cannot find the doctor they need in
their health plan they can go elsewhere.
"This Point of Service Amendment is about freedom of
choice for patients, about continuity and about getting people access to the
care that they need," Wellstone said. "Patients should have the right to choose
a doctor from the widest possible selection and continue their relationship with
a doctor whom they trust for as long as possible."
Wellstone's "Patient Advocacy Protection" Amendment says that plans cannot penalize doctors who advocate for patients during an appeals process. It also protects licensed and certified health care professionals from retaliation if they report problems (Whistleblowers) related to quality of care to (1) the hospital or plan, (2) proper regulatory authorities; or (3) private accreditation organizations.
"Protecting patient advocacy is about the trust between
patients and their doctors that is so essential to patients' satisfaction with
their health care," Wellstone said. "Patients should know they are receiving the
best medical advice from their doctors, who are free to speak on their patients'
behalf so that they receive the best care possible. Doctors should be free to
act on behalf of patients without fear of being penalized by a health plan. And
health plans should not be allowed to dump providers simply because they report
Wellstone's "Ombudsman" Amendment will establish an
Office of Consumer Information, Counseling and Assistance -- or ombudsman -- in
every state, to be administered by each state. An ombudsman provides many
important services including, consumer assistance with health insurance options,
establishment of a toll free hotline to answer questions promptly, consumer
education about patients' rights and responsibilities under their health plans,
assistance with internal and external appeals when necessary, and collection and
dissemination of timely health care information.
"Our current health care system is a maze. There is a lot
of confusion among people about their health insurance options, and their rights
and responsibilities in the managed care system," Wellstone said. "A
full-fledged ombudsman fills an important role, providing consumer assistance
and education and improving access to care and access to the appeals process.
Better educated consumers who are better able to access the care that they need
will mean fewer complaints, fewer appeals and fewer
Mental Health Care and Substance Abuse Treatment Amendments
Wellstone also offered amendments to prevent discrimination
by health plans against persons with mental illness and an amendment to prevent
plans from blocking or prohibiting patient access to available substance abuse
treatment or other behavioral health care services.
"People struggling with mental and emotional disorders need treatment and support, not termination from health plans because they have specific behaviors associated with their illness. This would be like dropping heart patients if they have chest pains," Wellstone said. "And people who are able should be allowed to pay their own money for behavioral care that is denied by plans. This is a small, but important common-sense fix to an unfortunate problem faced by many families with loved ones who need this care."