THE WHITE HOUSE
Office of the Press Secretary
PRESIDENT CLINTON ISSUES DIRECTIVE AIMED AT ENSURING THAT FEDERAL HEALTH PLANS COME INTO COMPLIANCE WITH THE PATIENTS' BILL OF RIGHTS
February 20, 1998
Today, the President is issuing an Executive Memorandum directing all Federal health plans, which serve over 85 million Americans, to come into substantial compliance with the President's Quality Commission's Consumer Bill of Rights (Patients' Bill of Rights). The Executive Memorandum follows a report that the Vice President forwarded to the President on the current status of compliance with the Consumer Bill of Rights. The President is also re-issuing his challenge to Congress to pass legislation that ensures that a patients' bill of rights will become the law of the land for all Americans. Today, the President is:
ANNOUNCING THAT THE NATION'S FEDERAL HEALTH PROGRAMS ARE LEADERS IN PROVIDING PATIENT PROTECTIONS. Today, the President accepted and praised the Vice President's report on the compliance status of Federal health programs with the Consumer Bill of Rights, including Medicare, Medicaid, Indian Health Service, the Federal Employee Health Benefits Program, the Department of Defense Military Health Program, and the Veteran's Health Program. Although citing shortcomings, the report concludes that Federal health plans are already largely in compliance. This finding illustrates that implementing consumer protections to help Americans navigate through a changing health care system, can be and has been done without excessive costs or regulations.
ISSUING AN EXECUTIVE MEMORANDUM TO ENSURE THAT THESE FEDERAL AGENCIES COME INTO SUBSTANTIAL COMPLIANCE WITH THE CONSUMER BILL OF RIGHTS. While the Federal government is taking a leading role to ensure consumer protections are in place, the Vice President's report concluded it has the authority to do more. Today, the President is issuing an Executive Memorandum to ensure that Federal programs come into substantial compliance with the Consumer Bill of Rights by no later than next year. His executive action:
Directs HHS to Take Administrative Actions to Ensure that Medicare Comes into Compliance with Rights, Including Access to Specialists, by Next Year. Medicare is largely in compliance with the Consumer Bill of Rights. However, Medicare currently does not ensure access to specialists and adequate levels of participation in treatment decisions. The President is directing HHS to issue administrative actions in these and other areas by no later than next year to bring Medicare, which serves over 38 million older Americans and people with disabilities, substantially into compliance.
Directs HHS to Take Administrative Actions to Ensure Greater Compliance for Medicaid, Including Access to Specialists, by Next Year. HHS has also determined that there are appropriate administrative actions it could take to ensure that the Medicaid program, which serves 36 million Americans, comes into substantial compliance with all of the major elements of the Consumer Bill of Rights. The President is also directing the Department to issue directives to bring Medicaid into substantial compliance by no later than next year. Directs HHS to Notify States Immediately that Emergency Room Services Are Covered Under Medicaid. The President is directing the Department to send a letter to State Medicaid directors to clarify that States are required to cover emergency room services consistent with the recommendations of the Consumer Bill of Rights.
Directs the Federal Employees Health Benefits Program (FEHBP) to Ensure 350 Participating Carriers Come into Compliance with the Consumer Bill of Rights by Next Year. The President is directing Office of Personnel Management (OPM), which manages FEHBP and its 9 million enrollees, to notify all 350 participating carriers that they must come into compliance with the Consumer Bill of Rights, particularly with regard to access to specialists, continuity of care, and access to emergency room services. He also is directing OPM to work with each participating carrier to ensure they come into full compliance with the Consumer Bill of Rights by the end of next year. OPM issues a call letter each March which sets forth FEHB Program and policy changes. To meet the President's directive, this year's letter will specifically address new expectations for participating carriers in areas such as: access to specialists, continuity of care, disclosure of financial incentives, and access to emergency room services.
Directs OPM to Publish New Regulations Prohibiting Gag Clauses. The President is directing OPM to publish a regulation in the next three months to ensure that gag clauses, which restrict physician-patient communications about medically necessary treatment options, not be a part of any provider agreement that includes FEHBP enrollees. These new actions build on OPM's existing consumer protections, including an internal and external appeals process and information disclosure rights.
Directs the Department of Defense (DoD) to Come into Compliance Through A Series of Policy Directives and Contractual Modifications. The President is directing DoD, which serves 6 million Americans to: (1) establish a strong grievance and appeal process for beneficiaries who have been denied services by managed care companies that are in contract with the Military Health System; (2) issue a directive to promote greater use of providers who have specialized training in women's health issues to serve as primary care managers for female beneficiaries; and (3) issue a directive to ensure that all patients in the military health system can fully discuss all treatments options, including prohibiting anti-gag clauses. These actions, to be completed by this fall, will bring the Military Health System into substantial compliance with the Consumer Bill of Rights.
Directs Veterans' Health Programs to Come into Compliance with the Consumer Bill of Rights Through a Series of Policy Initiatives. The President is directing the VA, which serves 3 million veterans, to use its administrative authority to ensure that an internal and external appeals process is in place and to issue a new directive to ensure that VA consumers meet the information disclosure recommendations in the Consumer Bill of Rights. The VA already assures many protections, such as access to specialists. This new action will bring the VA system into virtual compliance with the Consumer Bill of Rights.
Directs the Department of Labor to Use Its Limited Authority to Ensure Adequate Information Disclosure and a Stronger Internal Appeals Process. The Department of Labor is responsible for the administration and enforcement of the Employee Retirement Income Security Act (ERISA) which governs approximately 2.5 million private sector health plans that cover about 125 million Americans. Labor has extremely limited authority to ensure that these plans can come into compliance. Understanding this fact, the President is directing Labor to take action, by no later than this spring, to propose regulations to protect consumers by: (1) improving information disclosure rights; and (2) strengthening the internal appeals process for all ERISA plans, to ensure that decisions regarding urgent care are resolved within 72 hours and generally resolved within 15 days for non-urgent care.
RE-ISSUING CHALLENGE TO CONGRESS TO PASS FEDERALLY-ENFORCEABLE PATIENTS' BILL OF RIGHTS THIS YEAR. Today, the President renewed his call to Congress to pass a patients' bill of rights this year. The Department of Labor's report underscores that most consumer protections cannot be ensured to patients in private health plans without additional legislation. This legislation will ensure that the millions of Americans who are in private health plans will be protected, too.
RELEASING HHS CONSUMER SURVEY TO EMPOWER MEDICARE BENEFICIARIES TO MAKE INFORMED CHOICES. Today, the Consumer Assessment Health Plans Survey (CAHPS) is being released by HHS. This survey seeks information on how easily beneficiaries can access specialists, emergency care services, and the general level of consumer satisfaction. Survey results, which will provide extensive information about all Medicare managed care plans currently up and running, will be sent to every Medicare beneficiary this fall, helping them to make much-better informed choices about their health plan options.