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ACP-ASIM Urges Congress to Choose the Best Patient Protection Bill, S. 1052

July 19, 2001

(Washington, DC) The Bipartisan Patient Protection Act (BPPA), S. 1052, offers patients the most comprehensive and reliable set of guarantees, according to the American College of Physicians - American Society of Internal Medicine (ACP-ASIM.)

"Of any of the legislation being considered, the BPPA would best establish a dependable national standard for health plan operation that gives patients clear guarantees about the quality of care they can expect." stated William J. Hall, MD, FACP, president of ACP-ASIM.

According to Dr. Hall, BPPA would protect a patients' right to:

  • See specialists without undue interference. This means pregnant women could see their customary obstetricians and cancer patients their usual oncologists, even if they change health plans.
  • Make managed care plans justify health care decisions before an independent medical review panel when a patient and physician believe his/her health may be adversely affected. Such disputes would be resolved quickly without recourse to a lawsuit.
  • Hold a managed care company accountable in a court of law when it harms consumers, as is the norm in every other kind of business
  • .

The Senate bill offers more benefits than H.R. 2315 because it:

  • Provides better access to specialty care. The largest medical specialty societies and almost all patient groups have declined to endorse the more limited protections in H.R. 2315.
  • Creates easy reviews for denial of needed care. H.R. 2315 would allow managed care companies to demand burdensome paperwork of patients if they attempt to fight denials of needed care under $100. This requirement would leave many patients with no recourse if a needed test or visit is denied by a health plan.
  • Prevents excessive managed care paperwork demands. H.R. 2315 includes several provisions that will encourage health plans to demand excessive documents from patients and physicians in an attempt to delay, and thereby negate, the process for review of denied health care claims.
  • Protects state laws that hold insurers to a higher standard of accountability.

ACP-ASIM is the nation's largest medical specialty organization and the second largest physician group. Membership encompasses more than 115,000 internal medicine physicians and medical students. Internists are the major providers of medical care to adults in America.

Jack Pope, ACP-ASIM Washington Office, 202-261-4556

Page updated: 11-03-03

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