October 28, 2021

Regarding the recent story on HMO reform bills currently under consideration by the U.S. Senate (July 25-26), I want to make clear the scope of the Republican Patients’ Bill of Rights — a bill which has at its heart, the best interests of the patient.

The concerns that led to this bill are rooted in the changes in how we receive our health care. People worry that if they or their loved ones become seriously ill, their HMO will deny them coverage and force them to accept either inadequate care or financial ruin — or both.

Our Patients’ Bill of Rights provides a quick and free appeals process if your HMO refuses to allow a covered procedure. Contrary to the implication of the article, this process applies to all Americans who are insured by their employers, some 124 million people.

If your HMO denies you treatment that your doctor believes is medically necessary, you should not have to resort to a costly and lengthy court battle to get the care you need. If you are denied coverage, you should have the right to an expeditious review by an independent doctor — somebody not associated with your HMO — but a medical expert who can make sure you are being treated fairly. That is exactly what the Republican plan does. It gives patients the right to appeal a medical decision to a doctor quickly and at no cost to the patient.

And the decision of that doctor is binding on the HMO.

Our bill expands patients’ power and choice. These are provisions that will benefit everyone. Sen. Susan M. Collins Washington, D.C.

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