June 2001 Bulletin

AAOS supports bipartisan patients’ rights legislation

The American Association of Orthopaedic Surgeons has given its strong support to the Bipartisan Patients’ Bill of Rights legislation drafted by Sen. Bill Frist (R-Tenn.); Sen. James Jeffords (R-Vt.) and Sen. John Breaux (D-Va.).

William W. Tipton Jr., MD, AAOS Executive Vice President, said in a letter to President Bush, who supports the bill, and to the three senators that the legislation "contains true protections for our patients."

The bill requires patients to appeal to an independent review process before taking disputes against health insurers to federal court for damages. Once in court, damage awards under the bill would be capped at $500,000. The bill would ensure access to emergency and specialty care.

"Developed in a bipartisan manner, the bill addresses the concerns of both patients and physicians, and, importantly, ensures that managed care plans are accountable for their decisions through a timely, independent external appeals mechanism," Dr. Tipton said.

He said the legislation embodies the principles which the AAOS has supported in recent years. The principles are access to a full range of medically necessary specialty care in-network, the ability to seek treatment out-of-network for a non-cost prohibitive copayment and comprehensive information provided to all enrollees and prospective enrollees that allow them to make an informed choice about plan coverage. The AAOS principles also include a ban on "gag clauses" which prohibit physicians from discussing treatment options with patients and health care plan accountability through an expedited, independent external appeals mechanism.

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