Senate Aids Non-Physician Providers in Passing Patients’ Bill of Rights With the recent U.S. Senate passage of the Patients’ Bill of Rights, Congress has moved one step closer to landmark health legislation that could strengthen patient protections and expand opportunities for speech-language pathologists, audiologists, and other non-physician providers. As The ASHA Leader goes to press, the U.S. House of Representatives ... Features
Free
Features  |   August 01, 2001
Senate Aids Non-Physician Providers in Passing Patients’ Bill of Rights
Author Notes
Article Information
Regulatory, Legislative & Advocacy / ASHA News & Member Stories / Features
Features   |   August 01, 2001
Senate Aids Non-Physician Providers in Passing Patients’ Bill of Rights
The ASHA Leader, August 2001, Vol. 6, 1-4. doi:10.1044/leader.PA.06142001.1
The ASHA Leader, August 2001, Vol. 6, 1-4. doi:10.1044/leader.PA.06142001.1
With the recent U.S. Senate passage of the Patients’ Bill of Rights, Congress has moved one step closer to landmark health legislation that could strengthen patient protections and expand opportunities for speech-language pathologists, audiologists, and other non-physician providers. As The ASHA Leader goes to press, the U.S. House of Representatives is considering whether to move forward the Senate bill as written—which ASHA strongly supports—or craft a different version of the legislation.
Two important provisions in the Senate bill, S. 1052, strengthen the role of non-physician providers: a clause banning discrimination against non-physician providers by insurers or HMOs, and an amendment that would include non-physician providers on panels reviewing claim denials. Sens. John McCain (R-AZ) and Edward M. Kennedy (D-MA) sponsored S. 1052, which passed by a broad margin with a 59-36 vote on June 29.
The nondiscrimination language in the bill states that hospitals, insurers, or HMOs cannot discriminate against providers based upon licensure or certification. “If a health plan covers a service, it can’t eliminate a class of practitioners if the practitioner is licensed by the state to perform that service,” said Steven White, ASHA’s director of health care economics and advocacy.
ASHA has lobbied for nondiscrimination language since the early 1990s, when a coalition was formed to press the issue. The Association worked closely with Rep. Charlie Norwood (R-GA), who introduced a patients’ bill of rights in 1997.
“In the past, health plans that covered hearing tests could, for example, exclude licensed audiologists because we weren’t physicians, and limit access, choice, and competition,” noted Larry Higdon, ASHA’s vice president for governmental and social policies. “The Senate bill gives SLPs and audiologists direct access to review panels and health plans. It is an important step toward professional autonomy.”
Because of advocacy by ASHA and other groups, nondiscrimination language has been included in all versions of the patients’ rights legislation considered this year. ASHA’s effort to win nondiscrimination language for clinicians began years ago, and progress has been incremental. In 1999, the House and Senate passed patient protection bills that included a nondiscrimination provision. When the bills went to the House–Senate conference, that provision was agreed to, but the conference committee couldn’t agree on a final bill.
The second important component of the Senate bill—an amendment relating to claims review panels—would ensure that non-physician providers such as SLPs and audiologists are represented in panels that review claims.
S. 1052 states that claims denied by an insurance company or HMO may be examined by a peer review panel to determine if the denial was justified. As the Senate bill was written, however, the panels would include only physicians. Sen. Tom Harkin (D-IA) introduced an amendment to require that peer review panels examining claims for non-physician services include appropriate non-physician providers. ASHA worked closely with Harkin’s legislative staff and lobbied successfully to have the amendment included.
The Senate bill makes it easier for patients to secure a wide variety of medical services, including coverage for visits to the nearest emergency room, direct access to medical specialists, medically necessary prescription drugs, and participation in clinical trials for experimental treatments. To safeguard these new services, the Senate bill provides extensive new opportunities to challenge decisions by HMOs and insurers—including a two-tiered review process—and, if a patient remains unsatisfied, a right to sue insurers and HMOs over decisions that lead to injury or death.
The U.S. House of Representatives plans to take up similar legislation in the near future. If the House passes a bill this summer, a conference committee will then work out any necessary compromises. ASHA will continue its advocacy for House passage of the Senate-approved bill as it moves through the legislative process.
For further information, contact Reed Franklin through the Action Center at 800-498-2071, ext. 4473, or by email at rfranklin@asha.org.
0 Comments
Submit a Comment
Submit A Comment
Name
Comment Title
Comment


This feature is available to Subscribers Only
Sign In or Create an Account ×
FROM THIS ISSUE
August 2001
Volume 6, Issue 14