Kitzhaber signs 'Patients' Bill of Rights'

SALEM - Seated before a standing-room-only crowd of legislators, labor leaders, health care consumer advocates, health insurance executives and employer representatives, Oregon Governor John Kitzhaber signed into law May 30 Oregon's own "Patients' Bill of Rights."

"Patient protection and patient rights are fundamental to the quality of health care," Kitzhaber told the group. House Bill 3040 means that "certain people who have coverage can be confident that the system is truly responsive to their needs."

The patient protections contained in the new law include:

External review - Patients who are denied a service because their health plan says it is not medically necessary or experimental will have the right to an independent review of that decision at the plan's expense before a decision-maker selected by the state, not the health plan.

Right to sue - Patients will have a right to sue the plan if it does not follow the decision of the independent reviewer.

Continuity of care - Patients who are treating with a physician at the time a physician leaves their health maintenance organization (HMO) will have the right to continue treating with that physician for up to 120 days at the plan's expense.

Referrals to specialists - patients who are denied a referral to a specialist will have the right to a second opinion.

Network adequacy - the Department of Consumer and Business Services will develop uniform indicators for HMOs and other plan networks to use to measure and monitor the scope and adequacy of their provider networks, and the bill makes it an unfair trade practice for insurers to materially misrepresent certain information about the availability of services in their networks.

Kitzhaber praised the work group of labor, business, health insurers and consumers that reached agreement on the legislation and the "tenacity" of the Oregon AFL-CIO in leading that effort, following the state labor federation's co-sponsorship of several patient-protection ballot measures last year. The Oregon AFL-CIO withdrew those measures when the governor convened the work group and urged its members to negotiate a mutually-acceptable package of reforms, which eventually produced HB 3040.

Oregon AFL-CIO President Tim Nesbitt thanked Kitzhaber for his assistance in convening the work group and praised HB 3040 as "a win-win for consumers and employers," guaranteeing patient protections for our members and helping to rebuild consumer confidence in managed care as a cost-effect mechanism for delivering health care.

HB 3040 applies to all health care insurance products regulated by the state, but not to Taft-Hartley plans or self-insured employer plans (which are governed by federal law), nor to the Oregon Health Plan. Its provisions take effect July 1, 2002, which will allow time for health insurance carriers to incorporate them in their group health plan contracts.

(From the Weekly Update of the Oregon AFL-CIO)

June 15, 2001 issue

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