Patients' Bill of Rights Act of 2005

Bill: 109-s-1012
Sponsor: Sen. Kennedy, Edward M. [D-MA]
Introduced: 2005-05-12 in the Senate
Policy area: Health
Subjects: Abortion
Access to health care
Accreditation (Medical care)
Administrative procedure
Administrative remedies
Ambulances
Breast cancer
Cancer
Case management
Charitable contributions
Child health
Civil Rights and Liberties, Minority Issues
Civil actions and liability
Clinical trials
Coinsurance
Collective bargaining
Commerce
Communication in medicine
Confidential communications
Conflict of interests
Congress
Congressional investigations
Congressional reporting requirements
Consumer complaints
Consumer education
Cooperative societies
Corporation directors
Damages
Department of Health and Human Services
Department of Labor
Directories
Discrimination in insurance
Discrimination in medical care
Donation of organs, tissues, etc.
Drugs
Economics and Public Finance
Emergency Management
Emergency medicine
Employee health benefits
Employers' liability
Evaluation research (Social action programs)
Evidence (Law)
Excise tax
Families
Federal employees
Federal preemption
Federal-state relations
Fees
Finance and Financial Sector
Fines (Penalties)
Foundations
Freedom of speech
Government Operations and Politics
Government contractors
Government employees' health insurance
Government paperwork
Government publicity
Government trust funds
Governmental investigations
Grants-in-aid
Grievance procedures
Gynecology
Health insurance
Health insurance continuation
Health maintenance organizations
Health planning
Hospital care
Housing and Community Development
Humans
Income tax
Injunctions
Insurance premiums
Labeling
Labor and Employment
Labor contracts
Law
Legal fees
Liability (Law)
Licenses
Limitation of actions
Living wills
Managed care
Mastectomy
Medicaid
Medical economics
Medical ethics
Medical malpractice
Medical records
Medical screening
Medical supplies
Medical tests
Medically uninsured
Medicare
Minorities
Minority health
Nonprofit organizations
Obstetrics
Old age, survivors and disability insurance
Patient satisfaction
Patients' rights
Peer review organizations (Medicine)
Performance measurement
Pharmacists
Physician-patient privilege
Physicians
Pregnant women
Prescription pricing
Preventive medicine
Punitive damages
Quality of care
Reinsurance
Restrictive trade practices
Right of privacy
Rural health
Salaries
Science, Technology, Communications
Small business
Social Welfare
Social security finance
Standards
State laws
Subsidies
Surgery
Tax credits
Tax penalties
Taxation
Telephone
Terminal care
Terminally ill
Translating and interpreting
Transportation and Public Works
Welfare recipients
Whistle blowing
Women
Women's health

Summary:
action_date: 2005-05-12
text: 
Patients' Bill of Rights Act of 2005 - Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code to set forth requirements for health plans or issuers of health insurance coverage, including requirements for: (1) utilization review activities; (2) procedures for claims benefits processing, prior authorization determinations, appeals, and internal reviews; and (3) access for an independent, external review.
 
Requires the Secretary of Health and Human Services to establish the Health Care Consumer Assistance Fund to award grants to States for consumer assistance activities designed to provide information, assistance, and referrals to consumers of health insurance products.
 
Sets forth requirements for managed care programs and their access to care, including requiring such programs to: (1) offer coverage that allows for non-network coverage through another plan or issuer; (2) provide access to out-of-network emergency care without prior authorization; and (3) provide timely access to specialists.
 
Requires certain annual disclosures from health plans or issuers, including disclosures of covered benefits, cost-sharing requirements, and participating providers.
 
Prohibits a plan or issuer from: (1) restricting a health care professional's ability to advise a patient on the health of an individual or on medical care or treatment for the individual's condition or disease; and (2) operating any physician incentive plan.
 
Establishes a cause of action against a plan or issuer that fails to exercise ordinary care in making a decision that results in a personal injury or death to a participant or beneficiary.
 
Provides a tax credit to small businesses for expenses paid by the business for health insurance coverage of employees.


Legislative actions:
action_date: 2005-05-12
text: Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S5075-5099)
action_date: 2005-05-12
text: Sponsor introductory remarks on measure. (CR S5075)
action_date: 2005-05-12
text: Introduced in Senate