Key Patient Protections |
Patients' Bill of Rights Act,
S.6/H.R.358 |
Bilirakis/Hastert Bill, H.R.
448 |
Senate Republican Leadership Bill,
S.300 |
Ensure that treatment decisions — such as how long
patients can stay in the hospital after surgery — are made by health
professionals, not insurance companies. |
YES |
NO |
NO |
Hold plans accountable when their decisions to
withhold or limit care injure patients. |
YES |
NO |
NO |
Allow patients undergoing treatment to continue
with same provider if provider leaves plan or employer changes
plans. |
YES |
NO |
NO. Not when employer switches
plans, & only if patient is pregnant, in an institution, or
terminally ill. |
Allow patients to see outside specialist at no
additional cost when those in the plan can't meet their
needs. |
YES |
NO |
NO |
Require plans to have an adequate number and
variety of health care providers close to where consumers live &
work. |
YES |
NO |
NO |
Require plans to pay for emergency services if a
reasonable person would consider the situation an
emergency. |
YES |
NO. Definition does not include
severe pain, & plans can charge extra for non-network
provider. |
NO. Plans can refuse to cover or
charge extra for non-network provider. |
Ensure doctors & nurses can report quality
problems without retaliation from plans, hospitals, or other
institutions. |
YES |
NO |
NO |
Prevent health care professionals from being
financially rewarded for limiting a patient's care. |
YES |
NO |
NO |
Provide access to independent consumer assistance
program to help consumers choose plans & get services they
need. |
YES |
NO |
NO |
Promote access to clinical trials. |
YES |
NO |
NO |
Allow patients to appeal denials or limitations of
care to an external, independent entity whenever life or health is
jeopardized. |
YES |
NO. External review is not binding.
Reviewer not allowed to make objective determination of medical
necessity. |
NO. Plan defines medical necessity and
chooses reviewer. |
Give women direct access to ob/gyn services,
without limitations that impede access to services. |
YES |
NO. Direct access to physicians, but not to
other types of health care professionals in plan's network |
NO. Direct access to physicians, but not to
other types of health care professionals in plan's
network |