THE PATIENTS' BILL OF RIGHTS ACT

MEANS BETTER CARE FOR WOMEN

For women and families, few issues resonate as profoundly and pervasively as the need for quality health care. Both women and men care about health care quality, but women have a particular stake in the outcome of our nation's evolving health care system. Here is why:

• Women are the nation's primary health care decision-makers and consumers.
• Women spend most of our health care dollars.
• Women are the majority of enrollees in managed care plans.
• Women have unique health care needs that include, but go beyond, reproductive health.

The Patients' Bill of Rights Act (S. 6, H.R. 358) will help tip the balance back in favor of patients and their providers by establishing urgently needed common-sense patient protections. Many of the bill's provisions are especially important to women. For example, managed care plans would be required to:

• Allow women to choose an obstetrician/gynecologist as a primary care provider and to have direct access to ob-gyn services;

• Provide an external appeal when care is denied (women handle the bulk of insurance issues for their families). The bill also amends federal law to remove obstacles that prevent patients from holding health plans accountable for the decisions they make.

• Ensure access to clinical trials that may save women's lives;

• Ensure that pregnant women can continue to see the same health care provider throughout pregnancy if their provider leaves the plan or their employer changes plans;

• Allow health care professionals to prescribe drugs that are not on the plan's predetermined list when such drugs are medically indicated;

• Let treating physicians make decisions about things like how long patients stay in the hospital (for example, how long a woman undergoing a mastectomy should stay in the hospital);

• Have an internal quality improvement system that measures performance on health care issues that affect women;

• Collect data (and provide a summary of it to enrollees) that allows plans to evaluate how they are meeting the health needs of women;

• Incorporate gender-specific medicine when developing the plan's written clinical review criteria; and

• Ensure that providers and patients are not discriminated against on the basis of sex or other characteristics.

3/9/99

Click here for more information on the Patients' Bill of Rights Act (S. 1890/H.R. 3605).