Social Workers Support McCain-Edwards-Kennedy Patients' Bill of Rights Legislation (S. 1052)

Eighty-five percent of Americans support a Patients’ Bill of Rights that would require HMO’s, other managed care plans, and health insurance companies to provide people with more information about their health plan, make it easier for people to see medical specialists, allow appeals and independent reviewers when someone is denied coverage for a particular medical treatment, and give people the right to sue their health plans, according to a survey by the Kaiser Family Foundation and the Harvard School of Public Health.

"Appropriate care for patients is imperative. Patients must have access to timely and appropriate health and mental health care and they need to be able to have recourse if the insurer denies access to that care," says NASW Executive Director, Elizabeth J. Clark, PhD, ACSW, MPH.

NASW President, Ruth W. Mayden, MSS, LSW, agrees, and adds that it’s also important to understand that mental health care is as important as medical health care. "Insurers, as well as primary care physicians need to understand that people need access to many different types of care. Equal access to these different types of providers, including clinical social workers who provide more than half of the country’s mental health services, is necessary in providing the best care possible for everyone."

The Bipartisan Patient Protection Act of 2001 would guarantee that the health care practitioner would make the determination as to medical necessity. This ability is not only limited to physicians, but also to all qualified health and mental health practitioners who are licensed, accredited, or certified. The intent of the Patients’ Bill of Rights is to provide quality health care. When an insurer denies or delays care deemed medically necessary, the patient or the family should not be denied the ability to hold the insurer accountable for its actions through legal means.

The McCain-Edwards-Kennedy bill will mandate access to necessary specialists, including case managers. If the plan is insufficient for the patient’s needs, the plan must provide access to specialty care at no greater cost than if the benefit were obtained from participating providers. This provision ensures access while maintaining the integrity of health plan networks.

Finally, this legislation ensures that all health care providers who render services in accordance with their state license or certification are protected from discrimination by insurers with regard to plan participation or indemnification. This provision is critical for social workers as many of the plans deny legitimate claims for clinical and/or medical social work services.

For more information on NASW’s position on the Bipartisan Patient Protection Act of 2001, please contact Francesca Fierro O’Reilly , Senior Government Relations Associate at 202-336-8336 or fforeilly@naswdc.org.

Journalists, please contact NASW Public Affairs at 202-336-8228.

The National Association of Social Workers (NASW), in Washington, DC, is the largest membership organization of professional social workers with 153,000 members. It promotes, develops and protects the practice of social work and social workers. NASW also seeks to enhance the well being of individuals, families and communities through its work and through its advocacy.