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President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry

THE WHITE HOUSE

Office of the Press Secretary
For Immediate Release November 20, 1997

Today, the President endorsed the consumer bill of rights and responsibilities recommended by the Advisory Commission on Consumer Protection and Quality in the Health Care Industry. He stressed that the Commission's recommendations provide an excellent framework for long overdue national standards of consumer protection.

In accepting the recommendations, the President: (1) challenged all private health plans to adopt the Commission's consumer bill of rights; (2) called on Congress to pass appropriate Federal protections into law; and (3) directed every federal agency that administers or manages health plans to adopt the protections of the bill of rights and to advise where they need additional legislative authority to do so.

The President:

  1. CHALLENGED ALL PRIVATE HEALTH PLANS, PROVIDERS, AND HEALTH CARE FACILITIES TO ADOPT THE CONSUMER BILL OF RIGHTS.
    To take immediate steps to ensure that all affected stakeholders adopt the Commission's recemmendations, the President called on these parties to adopt the bill of rights. A voluntary call for compliance will not ensure that all Americans have access to these rights, but it represents an important first step.

  2. CALLED ON ALL PARTIES TO MAKE THESE RIGHTS REAL.
    To make these rights real for all Americans, the President called on Congress to pass the appropriate Federal protections into law before the 105th Congress adjourns. Some of these rights can be ensured administratively and some can be ensured through private accreditation, but clearly some will require Federal legislation. The President looks forward to working with the Commission and all other interested parties to work with the Congress in developing the appropriate balance of private, administrative, and legislative approaches. Republicans and Democrats alike have supported legislation providing consumer protections, and the President is optimistic that Congress will enact a measure he can sign into law in 1998.

  3. DIRECTED ALL FEDERAL AGENCIES TO COME INTO COMPLIANCE WITH THE BILL OF RIGHTS.
    To ensure that the Federal government takes the lead in providing consumer protections, the President directed the Department of Health and Human Services, the Department of Labor, the Department of Defense, the Department of Veteran Affairs, and the Office of Personnel Management to review the programs they administer and the plans they oversee to ensure they are consistent with the bill of rights. He instructed the agencies to exhaust every administrative action to make the programs they administer and the plans they oversee consistent with the bill of rights. He asked them to indicate what statutory limitations impede their ability in this regard. The President directed these agencies to report back to him through the Vice President on the status of this directive by February 1998.

CONSUMER BILL OF RIGHTS AND RESPONSIBILITIES

The Commission's consumer bill of rights consists of the following rights and responsibilities:

  1. Access to Accurate, Easily Understood Information about health plans, facilities, and professionals to assist consumers in making informed health care decisions;

  2. Choice of Health Care Providers that is sufficient to ensure access to appropriate high quality care. This right includes providing consumers with complex or serious medical conditions access to specialists, giving women access to qualified providers to cover routine women's health services, and ensuring continuity of care for consumers who are undergoing a course of treatment for a chronic or disabling condition;

  3. Access to Emergency Services when and where the need arises. This provision requires health plans to cover these services in situations where a prudent layperson could reasonably expect that the absence of care could place their health in serious jeopardy;

  4. Participation in Treatment Decisions including requiring providers to disclose any incentives -- financial or otherwise -- that might influence their decisions, and prohibiting gag clauses that restrict health care providers' ability to communicate with and advise patients about medically necessary options;

  5. Assurance that Patients are Respected and Not Discriminated Against, including prohibiting discrimination in the delivery of health care services based on race, gender, ethnicity, mental or physical disability, and sexual orientation;

  6. Confidentiality provisions that ensure that individually identifiable medical information is not disseminated and that provide consumers the right to review, copy, and request amendments to their medical records;

  7. Grievance and Appeals Processes for consumers to resolve their differences with their health plans and health care providers -- including an internal and external appeals process; and

  8. Consumer Responsibilities provisions that ask consumers to take responsibility by maximizing healthy habits, becoming involved in health care decisions, carrying out agreed-upon treatment plans, and reporting fraud.

Background on the Commission. The President created the 34-member Advisory Commission on Consumer Protection and Quality in the Health Care Industry on March 26, 1997, charging it with recommend[ing] such measures as may be necessary to promote and assure quality and value and protect consumers in the health care industry. The Commission is co-chaired by Secretary of Labor Alexis Herman and Secretary of Health and Human Services Donna Shalala. The Commission will submit its final comprehensive report on creating a quality framework to the President, through the Vice President, on March 30, 1998.

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Last Revised: Friday, June 19, 1998