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Patients deserve real and effective patient protections.
As you consider the competing bills in Conference, we implore you to press for a conference report that includes at a minimum, the following essential provisions. The medical profession supports federal legislation that establishes a minimum floor of patient protections, allowing stronger state patient protections to remain or be put in place. The final bill needs to guarantee all patients access to an independent external appeals process whenever the denial of benefits involves a medical judgment or concerns medical necessity. All patients deserve access to an independent, external review entity to determine if they have been improperly denied a covered medical benefit. For the process to be truly independent, the legislation must prohibit arbitrary health plan definitions of medical necessity from controlling coverage determinations.