106th Congress

MANAGED CARE REFORM/PATIENTS' BILL OF RIGHTS

ANA has been very active in pushing for strong, comprehensive, and enforceable patient protection legislation. ANA supported the original Patients' Bill of Rights introduced in the House and Senate in 1999, and is now strongly backing the provisions of the Norwood-Dingell Bipartisan Consensus Managed Care Act introduced in the House by Reps. Charlie Norwood (R-GA) and John Dingell (D-MI) in the Fall of 1999.

This compromise House bill, hammered out by two House members who have been in the forefront of debate on the patient protection issue, includes most of the protections contained in the Patients' Bill of Rights legislation that has been backed by President Clinton, the Democratic leadership in Congress, and a large number of consumer and provider groups throughout the nation, including ANA, the American Medical Association, and the AFL-CIO. With twenty Republicans and forty-five Democrats as original cosponsors, the new proposal gained instant credibility and became without question the best hope for passage of strong, comprehensive legislation in this Congress. The House passed Norwood-Dingell in October 1999 with a strong bipartisan vote.

An important provision for nursing, included in Norwood-Dingell, is the language from the original Patients' Bill of Rights that would protect health care professionals from retaliation when they advocate for their patients in institutional settings. Another important provision would require health plans to allow patients to have access to a full range of health care providers, with no discrimination against some providers solely on the basis of type of licensure. It would also ensure that women can obtain ob-gyn services from any participating health care professional who specializes in obstetrics and gynecology.

In addition to these important issues for nursing, Norwood-Dingell would ensure that patients have recourse to a genuinely independent external review when care is denied and would allow patients to hold their health plan accountable when plan decisions to withhold or limit care result in injury or death.

The version of managed care reform passed by the Senate in mid-July of 1999 resulted in an extremely disappointing and partisan half-measure. Since the House and Senate have acted on different versions of patient protection legislation, a House-Senate conference has been working since March 2000 to craft a final bill, but it has not been successful, and other parliamentary tactics are expected to be undertaken to force action on the issue. ANA is continuing to advocate for enactment of a strong, comprehensive and enforceable bill.

THE MESSAGE TO CONGRESS IS: As a registered nurse, I urge you to support enactment of strong, comprehensive, and enforceable protections embodied by the bipartisan Norwood-Dingell legislation. The final bill must include the whistleblower provision that protects nurses and other health care professionals from retaliation when they advocate for their patients. Patient advocacy is the cornerstone of my profession, and this provision is carefully crafted to allow me to exercise my ethical responsibility to my patients in institutional settings.

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