Right to Information. Patients have the right to receive accurate,
easily understood information to assist them in making informed decisions
about their health plans, facilities and professionals.
Right to Choose. Patients have the right to a choice of health
care providers that is sufficient to assure access to appropriate
high-quality health care including giving women access to qualified
specialists such as obstetrician-gynecologists and giving patients with
serious medical conditions and chronic illnesses access to specialists.
to Emergency Services. Patients have the right to access emergency
health services when and where the need arises. Health plans should
provide payment when a patient presents himself/herself to any emergency
department with acute symptoms of sufficient severity "including
severe pain" that a "prudent layperson" could reasonably
expect the absence of medical attention to result in placing that
consumer''''s health in serious jeopardy, serious impairment to bodily
functions, or serious dysfunction of any bodily organ or part.
a Full Partner in Health Care Decisions. Patients
have the right to fully participate in all decisions related to their
health care. Consumers who are unable to fully participate in treatment
decisions have the right to be represented by parents, guardians, family
members, or other conservators. Additionally, provider contracts should
not contain any so-called "gag clauses" that restrict health
professionals'''' ability to discuss and advise patients on medically
necessary treatment options.
Without Discrimination. Patients have the right to
considerate, respectful care from all members of the health care industry
at all times and under all circumstances. Patients must not be
discriminated against in the marketing or enrollment or in the provision
of health care services, consistent with the benefits covered in their
policy and/or as required by law, based on race, ethnicity, national
origin, religion, sex, age, current or anticipated mental or physical
disability, sexual orientation, genetic information, or source of payment.
Right to Privacy. Patients have the right to communicate with
health care providers in confidence and to have the confidentiality of
their individually-identifiable health care information protected.
Patients also have the right to review and copy their own medical records
and request amendments to their records.
Right to Speedy Complaint Resolution. Patients have the
right to a fair and efficient process for resolving differences with their
health plans, health care providers, and the institutions that serve them,
including a rigorous system of internal review and an independent system
of external review.
on New Responsibilities. In a health care system
that affords patients rights and protections, patients must also take
greater responsibility for maintaining good health.