IV

104TH CONGRESS

2D SESSION H. CON. RES. 214

Expressing the sense of the Congress that a patient has certain rights

regarding medical care that should be protected by law.

IN THE HOUSE OF REPRESENTATIVES

SEPTEMBER 12, 1996

Mrs. SMITH of Washington submitted the following concurrent resolution;

which was referred to the Committee on Commerce

CONCURRENT RESOLUTION

Expressing the sense of the Congress that a patient has

certain rights regarding medical care that should be protected by law.

Whereas a patient has the right to have access to all information relevant to the care or course of treatment to make

an appropriate health care decision;

Whereas certain health plans contain contractual clauses that

prevent a health care provider from providing all the information relevant to the care or course of treatment

available to a patient, and such clauses interfere with a

patient’s ability to make an appropriate health care decision;

Whereas a patient has the right to seek care from the health

care provider of the patient’s choice;
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Whereas a patient has the right to know all the benefits (including services, terms, and costs) and patient rights and

responsibilities under a health plan, but certain health

plans do not explain in plain English all those benefits

and patient rights and responsibilities under the plan;

Whereas a patient has the right to have access to the patient’s medical records as well as the right to control access to such records;

Whereas a patient has the right to choose a course of treatment even if it is not a course of treatment recommended

by the patient’s health care provider;

Whereas a patient has the right to medical care free from interference from a third party payer (such as an insurer)

and the right to make appropriate health care decisions

without fear of reprisal from a third party against the

patient or the health care provider;

Whereas a patient has the right to contract with a health

care provider on mutually agreeable terms, including the

option to use a patient’s own resources to purchase the

desired care or course of treatment;

Whereas while the number of managed care health plans has

increased, patients have experienced a corresponding erosion of these rights; and

Whereas knowledge of these rights and greater information

about health plans empowers patients: Now, therefore, be

it

1 Resolved by the House of Representatives (the Senate

2 concurring), That it is the sense of the Congress that the

3 law should protect a patient’s right to—
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1 (1) receive full disclosure from the patient’s

2 health care provider of information relevant to the

3 patient’s care or course of treatment, including the

4 risks and benefits of treatment and appropriate al5 ternatives;

6 (2) seek care from the health care provider of

7 the patient’s choice;

8 (3) receive full disclosure in plain English of

9 the terms of a health plan before signing up for the

10 plan, including a copy of the contract, benefits (in11 cluding services, terms, and costs) and patient rights

12 and responsibilities under a health plan, approval

13 procedures for services, a roster and qualification of

14 participating providers, referral procedures, financial

15 incentives offered to providers for restricting care,

16 and procedures for appeal of denials of claims;

17 (4) have access to the patient’s medical records,

18 and to limit access of such records to the patient, to

19 those directly involved with the patient’s care, and to

20 others designated by the patient;

21 (5) choose a course of treatment even if such

22 treatment is not recommended by the health care

23 provider;

24 (6) refuse interference from a third party payer

25 (such as an insurer) in the patient’s medical care,
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1 and to be confident that a decision to seek or decline

2 care will not result in penalties imposed by the third

3 party payer on the patient or the health care pro4 vider; and

5 (7) contract with a health care provider on mu6 tually agreeable terms, including the option to use

7 the patient’s own resources to purchase the desired

8 care.

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