When people get sick and need care, they are in a vulnerable position. It’s important for them to understand what’s going on with their health. They need to know who is going to treat them and why and what their options are.
That’s what patient autonomy is all about. It means patients have the right to make informed decisions about their care. The Right of Informed Consent is one of the protections spelled out in something called a Patient’s Bill of Rights (BOR). This is a list of guarantees to patients when it comes to their healthcare and providers.
The lowdown on BORs and why they’re so complicated
Some patient rights are protected at the federal level. For example, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 enforces the Right to Privacy. HIPAA protects our medical information from being shared without our permission.
But not all patient rights are protected by federal laws. That’s because there is no uniform patient BORs in the United States. Certain legal protections for patients vary from state to state. Some healthcare facilities and insurance plans, like Medicare, have their own BORs.
That’s why you should check with your provider or insurance plan to see if there’s a BOR for you to review. Be sure to check the applicable state-level laws and consult a legal professional if you feel your rights may have been violated and you want to file a complaint.
Three examples of patient rights protected by federal laws
Patient laws are subject to change. That’s because they are linked to government agencies and their policies. Legal protections may change when there is a new president in office. Or, sometimes they change when new people enter Congress or state legislatures.
Let’s go over three fundamental patient rights currently protected by federal laws:
- The Right to Respect
- The Right to Emergency Treatment
- The Right to Choose Providers
The Right to Respect
We have the right to receive safe, respectful care that is free of prejudice or discrimination.
Under which law?
There are several federal laws that make it illegal to discriminate against people due to:
- Age
- Race
- Religion
- National origin
- Disability
- Sex (including pregnancy, sexual orientation, and gender identity)
One of those laws is the Affordable Care Act (ACA) of 2010. Section 1557 prohibits discrimination against an individual for the reasons listed above. This applies to all covered health programs or activities.
What does this mean?
It means all healthcare-related entities must follow this law if they get financial reimbursement from the government (e.g., Medicare Part D). This covers most doctors’ offices and hospitals operating in the U.S. The law also targets private insurers in the ACA Marketplace.
Why is it important?
Everyone deserves to be healthy no matter what. This is the basis of health equity. Health equity means all people should have the chance to be healthy no matter who they are. Healthcare professionals have an ethical obligation to provide quality care to all.
How do I file a complaint?
You can file a complaint online with the Office of Civil Rights. You can do this if you believe a provider or facility discriminated against you or a loved one. You can also email your complaint to OCRComplaint@hhs.gov.
The Right to Emergency Treatment
We have the right to receive emergency care when and if we need it.
Under which law?
The Emergency Medical Treatment & Labor Act (EMTALA) of 1986 requires hospitals with emergency departments to do three things:
- Provide all patients with a medical screening examination (MSE)
- Stabilize any patients with an emergency medical condition
- Transfer or accept patients as needed
What does this mean?
It means all patients who visit the emergency room (ER) should be examined. The goal is to see if their condition is life-threatening. If so, the staff must accept the patient. If the hospital can’t treat the patient, they must transfer them to another hospital that can.
What does it not mean?
Some people think that ER staff are required by law to treat patients even if they can’t afford to pay. But this is not true. Not all medical conditions qualify for care mandated by EMTALA. These mandates go away as soon as the patient is stable (conscious and alert). Also, EMTALA only applies to hospitals that receive federal funding (e.g., Medicare reimbursement).
Why is it important?
Everyone deserves to receive life-saving care if they are experiencing a medical emergency. Note that patients still qualify for MSEs even when they aren’t U.S. citizens, don’t have insurance, or can’t afford to pay.
How do I file a complaint?
Contact the State Survey Agency in the state where the hospital is located to file a complaint if you feel an ER violated your rights under EMTALA. Be sure to include the hospital’s name, your name, what happened, and the date it happened.
The Right to Choose Providers
We have the right to choose our own providers.
Under which law?
The Affordable Care Act provides legal protections for patients. One is the right to choose any provider you want from your health plan’s provider network.
Also, section 1802 of the Social Security Act offers “basic freedom of choice” for Medicare and Medicaid beneficiaries. They can get health services from any qualified institution, agency, or person.
What does that mean?
Patients have the right to choose their providers whether they use Medicare, Medicaid, or a private insurance plan. There may be some exceptions to this rule. So, be sure to read the BOR from your provider or insurance plan carefully.
Why is this important?
Everyone deserves to find a qualified provider nearby who they can trust. Online reviews are not always reliable. And it can be hard to find information on their background and qualifications.
How do I find a doctor that takes my insurance?
MediFind makes it easy to find doctors in your network.
- Open the Find a Doctor tool. Select whether you want to search by health condition, type of specialist, or for a doctor by name.
- Next, there will be a series of questions for you to answer. This helps MediFind find the best results for your needs. It will pull up a web page that lists all the doctors who meet your criteria.
- From there, click each profile to read more about the doctor. You will see a brief overview of the insurance they accept. Double-check by calling their office to verify that they are in network with your health plan.
