Any individual or organization not scheduled for an oral appearance may submit a written statement for consideration by the Committee and for inclusion in the printed record of the hearing. Due process is a core value of the American legal system and has recently become an important health care issue. Virtually all private and public health organizations provide consumers with some form of complaint resolution, using varied procedures to respond to consumer complaints. The court ordered HCFA to provide seniors with detailed information concerning grievances, hearings and appeals.
Many States require health insurers to provide certain complaint procedures.
More than thirty States have some specific complaint procedures that health plans must follow. A growing number of States are also requiring expedited appeals for denials of urgently needed care. While concerns have been raised about current regulations, in fact, many insurers and health care organizations are already going beyond the requirements of existing State and Federal law. Patient satisfaction in resolving disputes is a key element for maintaining confidence in the American health care system. The Subcommittee will examine the different types of appeals procedures used in Medicare and in private markets, and what progress HCFA has made in improving patient appeals.