June 25, 2015

PATIENT BILL of RIGHTS

Posted in DOCTORS, LEGAL ISSUES, MEDICAL tagged , , , , , , , , , , , , at 6:31 pm by PCOSLady

http://www.nhballantynemedicalgroup.org/home/patient-bill-of-rights.aspx

Your Rights in Health Care:

PATIENT BILL of RIGHTS

You have the following rights. If someone is helping you make healthcare decisions, he or she may exercise these rights for you.

~O~

Quality of care – you have the right to:

  • ~ Quality care by skilled doctors and staff.
  • ~ Be treated for your pain.
  • ~ Treatment that is as comfortable as possible.
  • ~ Emergency procedures without unnecessary delays.
  • ~ Help decide the details of your plan of care.
  • ~ Ask for a second opinion, at your expense.

~O~

Safety – you have the right to:

  • ~ Safe care.
  • ~ Know when something goes wrong with your care.
  • ~ Have a family member or friend, as well as your doctor, notified promptly of your admission to the hospital.
  • ~ Be free from all forms of abuse and neglect.
  • ~ Be free from all use of restraints unless needed for safety.

~O~

Voice and choice – you have the right to:

  • ~ Get information in a manner you understand.
  • ~ Make informed decisions about your care.
  • ~ Refuse care.
  • ~ Make advance directives and have your medical wishes followed.
  • ~ Contact a person or agency to protect your rights.
  • ~ Have a support person with you for emotional support.
  • ~ Agree to refuse to allow pictures for purposes other than your care.
  • ~ Religious and other spiritual services that you choose.
  • ~ Complain without fear and have your complaints reviewed.

~O~

Affordability – you have the right to:

  • ~ A detailed bill and an explanation of that bill.
  • ~ Information about resources to help pay for your healthcare.

~O~

Authentic personalized relationships – you have the right to:

  • ~ Know the names and jobs of the people who care for you.
  • ~ Privacy and access to medical information as described in Novant’s Notice of Privacy Practices.
  • ~ Be treated with respect and dignity.
  • ~ Treatment without discrimination.
  • ~ Respect for your culture, values, beliefs and preferences.
  • ~ Visitors of your choices. We will inform you of any restrictions.
  • ~ Personal privacy.

~O~

Easy for me – you have the right to:

  • ~ Sleep in the hospital without being awakened unless necessary.
  • ~ Know about rules that apply to your actions.
  • ~ Help in discharge planning from the hospital.

~O~

What is your role in your healthcare?

  • ~ Be an active partners in your healthcare.
  • ~ Ask questions.
  • ~ Keep appointments.
  • ~ Be respectful to other people and their property.
  • ~ Follow the facility’s rules.
  • ~ Follow your care instructions.
  • ~ Share as much health information with us as possible.
  • ~ Tell us about changes in your condition.
  • ~ Tell us when you are in pain.
  • ~ Give us a copy of your advance directive(s).
  • ~ Leave your valuables at home.
  • ~ Pay for your care.
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June 14, 2012

Patient’s Bill of Rights

Posted in LEGAL ISSUES tagged , , , , , , , , , , , , , , , at 11:20 pm by PCOSLady

PATIENT CARE ACT ~ PATIENT’S BILL OF RIGHTS ~ HEALTH REFORM ~ AFFORDABLE CARE ACT
~
http://healthreform.gov/newsroom/new_patients_bill_of_rights.html
~ Health Reform … Patient Care Act, signed June 22, 2010… Fact sheet …
~
Fact Sheet: The Affordable Care Act’s New Patient’s Bill of Rights
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June 22, 2010
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A major goal of the Affordable Care Act – the health insurance reform legislation President Obama signed into law on March 23 – is to put American consumers back in charge of their health coverage and care. Insurance companies often leave patients without coverage when they need it the most, causing them to put off needed care, compromising their health and driving up the cost of care when they get it. Too often, insurance companies put insurance company bureaucrats between you and your doctor. The Affordable Care Act cracks down on the some of the most egregious practices of the insurance industry while providing the stability and the flexibility that families and businesses need to make the choices that work best for them.
~
Today, the Departments of Health and Human Services (HHS), Labor, and Treasury issued regulations to implement a new Patient’s Bill of Rights under the Affordable Care Act – which will help children (and eventually all Americans) with pre-existing conditions gain coverage and keep it, protect all Americans’ choice of doctors and end lifetime limits on the care consumers may receive. These new protections apply to nearly all health insurance plans.1
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How These New Rules Will Help You
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~ Stop insurance companies from limiting the care you need. For most plans starting on or after September 23, these rules stop insurance companies from imposing pre-existing condition exclusions on your children; prohibit insurers from rescinding or taking away your coverage based on an unintentional mistake on an application; ban insurers from setting lifetime limits on your coverage; and restrict their use of annual limits on coverage.
~
~ Remove insurance company barriers between you and your doctor. For plans starting on or after September 23, these rules ensure that you can choose the primary care doctor or pediatrician you want from your plan’s provider network, and that you can see an OB-GYN without needing a referral. Insurance companies will not be able to require you to get prior approval before seeking emergency care at a hospital outside your plan’s network. These protections apply to health plans that are not grandfathered.
~
Builds On Other Affordable Care Act Policies
~
These new protections complement other parts of the Affordable Care Act including:
~
~ Reviewing Insurers’ Premium Increases. HHS recently offered States $51 million in grant funding to strengthen review of insurance premiums. Annual premium hikes can put insurance out of reach of many working families and small employers. These grants are a down-payment that enable States to act now on reviewing, disclosing, and preventing unreasonable rate hikes. Already, a number of States, including California, New York, Maine, Pennsylvania and others are moving forward to improve their oversight and require more transparency of insurance companies’ requests to raise rates.
~
~ Getting the Most from Your Premium Dollars. Beginning in January, the Affordable Care Act requires individual and small group insurers to spend at least 80% and large group insurers to spend at least 85% of your premium dollars on direct medical care and efforts to improve the quality of care you receive – and rebate you the difference if they fall short. This will limit spending on overhead and salaries and bonuses paid to insurance company executives and provide new transparency into how your dollars are spent. Insurers will be required to publicly disclose their rates on a new national consumer website – HealthCare.gov.
~
Keeping Young Adults Covered. Starting September 23, children under 26 will be allowed to stay on their parent’s family policy, or be added to it. Group health plans that are grandfathered plans can limit this option to adult children that don’t have another offer of employment-based coverage. Many insurance companies and employers have agreed to implement this program early, to avoid a gap in coverage for new college graduates and other young adults.
~
~ Providing Affordable Coverage to Americans without Insurance due to Pre-existing Conditions: Starting July 1, Americans locked out of the insurance market because of a pre-existing condition can begin enrolling in the Pre-existing Condition Insurance Plan (PCIP). This program offers insurance without medical underwriting to people who have been unable to get it because of a preexisting condition. It ends in 2014, when the ban on insurers refusing to cover adults with pre-existing conditions goes into effect and individuals will have affordable choices through Exchanges – the same choices as members of Congress.
~
New Consumer Protections Starting As Early As This Fall
~
The new Patient’s Bill of Rights regulations detail a set of protections that apply to health coverage starting on or after September 23, 2010, six months after the enactment of the Affordable Care Act. They are:
~
~ No Pre-Existing Condition Exclusions for Children Under Age 19. Each year, thousands of children who were either born with or develop a costly medical condition are denied coverage by insurers. Research has shown that, compared to those with insurance, children who are uninsured are less likely to get critical preventive care including immunizations and well-baby checkups. That leaves them twice as likely to miss school and at much greater risk of hospitalization for avoidable conditions.
~ A Texas insurance company denied coverage for a baby born with a heart defect that required surgery. Friends and neighbors rallied around the family to raise the thousands of dollars needed to pay for the surgery and put pressure on the insurer to pay for the needed treatment. A week later the insurer backed off and covered the baby.2
~ The new regulations will prohibit insurance plans from denying coverage to children based on a pre-existing conditions. This ban includes both benefit limitations (e.g., an insurer or employer health plan refusing to pay for chemotherapy for a child with cancer because the child had the cancer before getting insurance) and outright coverage denials (e.g., when the insurer refuses to offer a policy to the family for the child because of the child’s pre-existing medical condition). These protections will apply to all types of insurance except for individual policies that are “grandfathered,” and will be extended to Americans of all ages starting in 2014.
~
~ No Arbitrary Rescissions of Insurance Coverage. Right now, insurance companies are able to retroactively cancel your policy when you become sick, if you or your employer made an unintentional mistake on your paperwork.
~ In Los Angeles, a woman undergoing chemotherapy had her coverage cancelled by an insurer who insisted her cancer existed before she bought coverage. She faced more than $129,000 in medical bills and was forced to stop chemotherapy for several months after her insurance was rescinded.3
~
Under the regulations, insurers and plans will be prohibited from rescinding coverage – for individuals or groups of people – except in cases involving fraud or an intentional misrepresentation of material facts. Insurers and plans seeking to rescind coverage must provide at least 30 days advance notice to give people time to appeal. There are no exceptions to this policy.
~
~ No Lifetime Limits on Coverage. Millions of Americans who suffer from costly medical conditions are in danger of having their health insurance coverage vanish when the costs of their treatment hit lifetime limits set by their insurers and plans. These limits can cause the loss of coverage at the very moment when patients need it most. Over 100 million Americans have health coverage that imposes such lifetime limits.
~ A teenager was diagnosed with an aggressive form of leukemia requiring chemotherapy and a stay in the intensive care unit. He reached his family’s plan’s $1 million lifetime limit in less than a year. His parents had to turn to the public for help when the hospital informed them it needed either $600,000 in certified insurance or a $500,000 deposit to perform the bone marrow transplant he needed.4
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The regulation released today prohibits the use of lifetime limits in all health plans and insurance policies issued or renewed on or after September 23, 2010.
~
~ Restricted Annual Dollar Limits on Coverage. Even more aggressive than lifetime limits are annual dollar limits on what an insurance company will pay for health care. Annual dollar limits are less common than lifetime limits, involving 8 percent of large employer plans, 14 percent of small employer plans, and 19 percent of individual market plans. But for people with medical costs that hit these limits, the consequences can be devastating.
~
~ One study found that 10 percent of cancer patients reached a limit of what insurance would pay for treatment – and a quarter of families of cancer patients used up all or most of their savings on treatment.5
~
The rules will phase out the use of annual dollar limits over the next three years until 2014 when the Affordable Care Act bans them for most plans. Plans issued or renewed beginning September 23, 2010, will be allowed to set annual limits no lower than $750,000. This minimum limit will be raised to $1.25 million beginning September 23, 2011, and to $2 million beginning on September 23, 2012. These limits apply to all employer plans and all new individual market plans. For plans issued or renewed beginning January 1, 2014, all annual dollar limits on coverage of essential health benefits will be prohibited
~
Employers and insurers that want to delay complying with these rules will have to win permission from the Federal government by demonstrating that their current annual limits are necessary to prevent a significant loss of coverage or increase in premiums. Limited benefit insurance plans – which are often used by employers to provide benefits to part-time workers — are examples of insurers that might seek this kind of delay. These restricted annual dollar limits apply to all insurance plans except for individual market plans that are grandfathered.
~
Protecting Your Choice of Doctors. Being able to choose and keep your doctor is a key principle of the Affordable Care Act, and one that is highly valued by Americans. People who have a regular primary care provider are more than twice as likely to receive recommended preventive care; are less likely to be hospitalized; are more satisfied with the health care system, and have lower costs. Yet, insurance companies don’t always make it easy to see the provider you choose. One survey found that three-fourths of OB-GYNs reported that patients needed to return to their primary care physicians for permission to get follow-up care.
~
Read the complete Fact Sheet at the site…
~
HealthReform.gov

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