AQCA ‘99

                       The Key Points Of The Access to Quality Care Act of 1999

      Freedom of Choice
      Every American should be able to choose their doctor and hospital.

      Freedom to Change
      Every American should be able to change their choice of doctor on a regular basis if they feel
      the need.

      Local Health Services
      No American should be forced to drive out of town to see a doctor or go to a hospital when
      there is one available in their community to their liking.

      Specialists
      Every American should be able to see a specialist if their doctor thinks they need one.

      Obstetricians, Gynecologists, and Pediatricians
      Women should be able to see obstetricians and gynecologists, and children should be able to
      see pediatricians, without any referral.

      Continued Care
      Patients should not be forced to change doctors and hospitals while in the middle of being
      treated for a problem.

      Guaranteed Emergency Room Care
      Patients should be able to go to the nearest emergency room when they think they have an
      emergency, and should pay no more out-of-pocket than they would have at their health plan’s
      designated hospital. If the problem reasonably appeared to be an emergency, but turned out
      not to be, the insurance plan still has to pay.

      Patient Rights When A Benefit Is Denied
      Patients should be able to talk to health plan doctor, not just an insurance clerk, when a plan
      denies coverage. If the plan still denies coverage, they should be able to have a third opinion
      from medical specialists totally independent from the health plan, and that decision should be
      binding on the plan. If the health plan incorrectly denies the third opinion on grounds that the
      benefit in question is not included in the plan, the patient should be able to go to federal court,
      and sue for not only the benefit, but attorney’s fees, court costs, and up to $250,000 in
      penalties if the plan is found to be wrong.

      Compensation For Injuries From Denied Benefits
      If a patient is injured as a result of a covered benefit being denied or delayed, they should be
      able to go to state court and sue for compensatory and punitive damages for medical
      malpractice. Very importantly, employers cannot be held indirectly liable for the actions of a
      health plan.

      Incentives To Deny Care
      No health plan may provide payment incentives for doctors or hospitals to deny care.
      Reasonable flat rate payments and employment agreements are allowed, but only if they do
      not indirectly provide incentives to ration care.

      Readable Contracts
      Every American should be able to clearly understand what benefits are and are not covered
      by their health plan, before they agree to the coverage. Plans should provide specific
      information in laymen’s terms, in addition to information on the rights of patients to challenge
      plan decisions.

      Privacy
      No medical information on a patient should be released to anyone without the patient’s
      approval.

      Freedom Of Communication
      Every doctor should be free to discuss anything relative to a patient’s health with the patient,
      even if the information may be negative towards the health plan. Health plans should not fire
      or discipline doctors for talking freely with their patients.

      Better Health Plan Policies
      All health plans should develop policies with the input of patients and doctors; should maintain
      on-going programs to increase quality of care; should develop standardized participation rules
      for doctors and hospitals; and should develop policies to ensure patient care if the company
      runs out of money.

      CONGRESSMAN CHARLIE NORWOOD
      1707 LONGWORTH BUILDING
      WASHINGTON,DC 20515

       http://www.house.gov/norwood