Patient Bill Of Rights

There’s More Than One Patient Bill of Rights

There is no one single Patient Bill of Rights. Over the years there have been many different patient rights proposed by various organizations, and even by the government. In addition, the affordable Care Act goes a long way to changing those rights as well. Although every patient bill of rights cannot be discussed, we have included brief discussions on two of the most influential, those rights under the affordable Care Act, to be fully implemented in 2014, and those under the 1997-1998 Bill of Rights Report to the President of the United States that was prepared by the Advisory Commission on Consumer Protection and Quality in the Health Care Industry, which is still relevant today.

The Patient’s Bill of Rights

While these new rights from 2010 are taking effect, older bills of rights still apply. Here is a summary of the Consumer Bill of Rights and Responsibilities that was adopted by the US Advisory Commission on Consumer Protection and Quality in the Health Care Industry in 1998.

This bill of rights also applies to the insurance plans offered to federal employees. Many other heath insurance plansand facilities have also adopted these values. Even Medicare and Medicaid stand by many of them. This bill of rights addresses 8 key areas:

Access to Emergency Services

Consumers have the right to access emergency health care services when and where the need arises. Health plans should provide payment when a consumer presents to an emergency department with acute symptoms of sufficient severity — including severe pain — such that a “prudent layperson” could reasonably expect the absence of medical attention to result in placing that consumer’s health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.

Participation in Treatment Decisions

Consumers have the right and responsibility to fully participate in all decisions related to their health care. Consumers who are unable to fully participate in treatment decisions have the right to be represented by parents, guardians, family members, or other conservators.

Confidentiality of Health Information

Consumers have the right to communicate with health care providers in confidence and to have the confidentiality of their individually identifiable health care information protected. Consumers also have the right to review and copy their own medical records and request amendments to their records.

Consumer Responsibilities

In a health care system that protects consumers’ rights, it is reasonable to expect and encourage consumers to assume reasonable responsibilities. Greater individual involvement by consumers in their care increases the likelihood of achieving the best outcomes and helps support a quality improvement, cost-conscious environment.

Choice of Providers and Plans

Consumers have the right to a choice of health care providers that is sufficient to ensure access to appropriate high-quality health care. This includes Provider Network Adequacy, Access to Qualified Specialists for Women’s Health Services, Access to Specialists, and Transitional Care.

Respect and Nondiscrimination

Consumers have the right to considerate, respectful care from all members of the health care system at all times and under all circumstances. An environment of mutual respect is essential to maintain a quality health care system. Consumers must not be discriminated against in the delivery of health care services consistent with the benefits covered in their policy or as required by law based on race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation, genetic information, or source of payment. Consumers who are eligible for coverage under the terms and conditions of a health plan or program or as required by law must not be discriminated against in marketing and enrollment practices based on race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation, genetic information, or source of payment.

Complaints and Appeals

All consumers have the right to a fair and efficient process for resolving differences with their health plans, health care providers, and the institutions that serve them, including a rigorous system of internal review and an independent system of external review.