1.
Information Disclosure. Consumers have the right to receive accurate, easily
understood information and some require assistance in making informed health
care decisions about their health plans, professionals, and facilities.
2. Choice of
Providers and Plans. Consumers have the right to a choice of health care
providers that is sufficient to ensure access to appropriate high-quality
health care.
3. Access to
Emergency Services. Consumers have the right to access emergency health care
services when and where the need arises. Health plans should provide payment
when a consumer presents to an emergency department with acute symptoms of
sufficient severity -- including severe pain -- such that a "prudent
layperson" could reasonably expect the absence of medical attention to
result in placing that consumer's health in serious jeopardy, serious impairment
to bodily functions, or serious dysfunction of any bodily organ or part.
4.
Participation in Treatment Decisions. Consumers have the right and
responsibility to fully participate in all decisions related to their health
care. Consumers who are unable to fully participate in treatment decisions have
the right to be represented by parents, guardians, family members, or other
conservators.
5. Respect
and Nondiscrimination. Consumers have the right to considerate, respectful care
from all members of the health care system at all times and under all
circumstances. An environment of mutual respect is essential to maintain a
quality health care system.
6.
Confidentiality of Health Information. Consumers have the right to communicate
with health care providers in confidence and to have the confidentiality of
their individually identifiable health care information protected. Consumers
also have the right to review and copy their own medical records and request
amendments to their records.
7. Complaints
and Appeals. All consumers have the right to a fair and efficient process for
resolving differences with their health plans, health care providers, and the
institutions that serve them, including a rigorous system of internal review
and an independent system of external review.
8. Consumer
Responsibilities. In a health care system that protects consumers' rights, it
is reasonable to expect and encourage consumers to assume reasonable
responsibilities. Greater individual involvement by consumers in their care
increases the likelihood of achieving the best outcomes and helps support a
quality improvement, cost-conscious environment.
