Patients' Bill of Rights Act of 2005

A bill to amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to protect consumers in managed care plans and other health coverage

5/12/2005--Introduced.
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.


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Sponsor

• Sen. Edward Kennedy [D, MA]
• and 13 Co-Sponsors
  • Sen. Barbara Boxer [D, CA]
  • Sen. Maria Cantwell [D, WA]
  • Jon Corzine
  • Mark Dayton
  • Sen. Byron Dorgan [D, ND]
  • Sen. Thomas Harkin [D, IA]
  • Sen. Frank Lautenberg [D, NJ]
  • Sen. Carl Levin [D, MI]
  • Sen. Barbara Mikulski [D, MD]
  • Sen. Patty Murray [D, WA]
  • Sen. John Reed [D, RI]
  • Sen. Charles Schumer [D, NY]
  • Sen. Debbie Ann Stabenow [D, MI]
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Committees

• Senate Finance

Amendments

This bill has no amendments.

Amendments to S.1012

Number	Status	Purpose

Bill Status

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Introduced		Voted on by Senate		Voted on by House		Considered By President		Bill Becomes Law
May 12, 2005

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All Bill Actions

• Introduced on May 12, 2005.
• May 12, 2005: Read twice and referred to the Committee on Finance.

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Related Issue Areas:

• Budgets
• Emergency management
• Government trust funds
• Grants-in-aid
• 147 more
• Minorities
• Transportation
• Civil liberties
• Civil rights
• Finance
• Administrative procedure
• Administrative remedies
• Business
• Congress
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• Consumers
• Executive departments
• Government employees
• Government information
• Government paperwork
• Law
• Limitation of actions
• Right of privacy
• Telecommunication
• Communications
• Department of Health and Human Services
• Congressional reporting requirements
• Federal-state relations
• Labor
• Medical care
• Medicine
• Salaries
• Standards
• State and local government
• Federal employees
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• Liability (Law)
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• Social services
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• Governmental investigations
• Government publicity
• Evidence (Law)
• Women
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• Children
• Fines (Penalties)
• Health policy
• Pediatrics
• Quality of care
• Fees
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• Nonprofit organizations
• Taxation
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• Performance measurement
• Insurance premiums
• Managed care
• Pharmacists
• Politics and government
• Access to health care
• Case management
• Coinsurance
• Donation of organs, tissues, etc.
• Drugs
• Emergency medicine
• Employee health benefits
• Health insurance
• Hospital care
• Medical economics
• Medical records
• Prescription pricing
• Collective bargaining
• Government employees' health insurance
• Legal fees
• Welfare
• Conflict of interests
• Small business
• Income tax
• Charitable contributions
• Restrictive trade practices
• Social security
• Federal preemption
• Grievance procedures
• Whistle blowing
• Breast cancer
• Evaluation research (Social action programs)
• Medical screening
• Preventive medicine
• Women's health services
• Abortion
• Consumer complaints
• Telephone
• Consumer education
• Aged
• Discrimination in insurance
• Discrimination in medical care
• Department of Labor
• Rural affairs
• Communication in medicine
• Health planning
• Medical tests
• Rural health
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• Confidential communications
• Directories
• Physicians
• State politics and government
• Reinsurance
• Ambulances
• Cancer
• Medicaid
• Medicare
• Patients' rights
• Surgery
• Foundations
• Labeling
• Corporation directors
• Tax penalties
• Accreditation (Medical care)
• Minority health
• Medical ethics
• Tax credits
• Excise tax
• Terminally ill
• Health maintenance organizations
• Medical malpractice
• Patient satisfaction
• Freedom of speech
• Subsidies
• Health insurance continuation
• Clinical trials
• Terminal care
• Labor contracts
• Cooperative societies
• Pregnant women
• Welfare recipients
• Obstetrics
• Living wills
• Employers' liability
• Punitive damages
• Medically uninsured
• Peer review organizations (Medicine)
• Mastectomy
• Old age, survivors and disability insurance
• Translating and interpreting
• Physician-patient privilege
• Social security finance
• Gynecology
• Humans

Data from the Congressional Research Service

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