New York's Senator
CHARLES E. SCHUMER

FOR IMMEDIATE RELEASE June 20, 2001


SCHUMER CALLS FOR SWIFT PASSAGE OF PATIENTS' BILL OF RIGHTS

Bill would protect patients from HMO abuses, hold insurance companies accountable for medical decisions

Schumer: Patients' Bill of Rights puts control over health care back in the hands of patients and doctors

New Yorkers could see vastly improved health care quality if opponents of the bipartisan Patients' Bill of Rights stop holding up the measure and allow the Senate to begin work on reforming the managed health care system, US Senator Charles E. Schumer said today.

"For millions of Americans, a routine trip to the doctor is anything but routine," said Schumer. "Managed care has created a system where people's prescriptions are filled out by the dictates of an insurance company, and not the educated decision of their doctor. The Patients' Bill of Rights would give people the peace of mind that their doctor will have the final say in their healthcare, not an insurance representative hundreds of miles away."

About 14,000 physicians every day report seeing patients who were denied coverage of a recommended prescription drug and 10,000 report seeing patients who were denied coverage of a needed diagnostic test, according to a survey conducted by the Kaiser Family Foundation and the Harvard School of Public Health. A related survey from the U.C. Berkeley School of Public Health found that 35,000 patients every day report a delay in needed care because of their HMO.

The Patients' Bill of Rights would reform the way health insurance companies operate by loosening their control over a patient's care. Schumer said the bill is vital to improving health care for the nearly 180 million Americans who would be covered under the bill. Among the provisions in the legislation are the following:

1. Establishes independent external appeals panels to review HMO decisions denying or limiting medical care.
   
2. Holds managed care companies accountable when an HMO's decision to withhold care results in injury or death - cases concerning medical judgement will go to state court and cases concerning administrative decisions will go to federal court.
3. Guarantees access to specialist care, even if the patient needs to see an out-of-network doctor.
   
4. Ensures that patients can get access to emergency room care whenever and wherever they may need it.
   
5. Allows women to choose an OB/GYN as their primary care physician.
   
6. Requires that health insurance plans cover the costs of potentially live-saving experimental treatments.
   
7. Assures that HMOs cannot "gag" doctors to prevent them from discussing all possible treatment options with their patients.

The McCain-Edwards-Kennedy Patients' Bill of Rights, which Schumer is co-sponsoring, has the support of a majority of both houses of Congress. Over 500 doctors' and patients' groups have endorsed the legislation.

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