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May 30, 2001, Letter to Senators Urging Passage of Patients' Bill of Rights


May 30, 2001, Letter to Senators Urging Passage of
Patients' Bill of Rights

AHQA has endorsed the section of S. 283 which pertains to external appeals. It contains language that instructs the Secretary of Labor to give "deference" to entities that currently hold state and federal contracts for external review when setting up a certification process for the external appeals entities under the new law. This would provide for a simplified certification process for PROs who want to enter this new area of work. The section also requires reviewers to be "actively practicing" two days per week -- which AHQA has maintained appropriately narrows the field of applicants to those most highly qualified such as the PROs.

AHQA sent the letter below to the following Senators who have been identified by the Patients' Bill of Rights Coalition as those either needing encouragement to begin supporting or to continue supporting the bill -- or Senators that must use their leadership to get the bill passed. Each letter contained the name, address, phone and fax of the appropriate PRO for their state:

Evan Bayh (D-IN)
Mary Landrieu (D-LA)
Zell Miller (D-GA)
Ben Nelson (D-NE)
Conrad Burns (R-MT)
Ben Nighthorse Campbell (R-CO)
Thad Cochran (R-MS)
Susan Collins (R-ME)

Tom Daschle (D-SD)
Mike DeWine (R-OH)
Pete Domenici (R-NM)
John Edwards (D-NC)
Peter Fitzgerald (R-IL)
Charles Grassley (R-IA)
Tim Hutchinson (R-AR)
Edward Kennedy (D-MA)
Jon Kyl (R-AZ)

John McCain (R-AZ)
Jeff Sessions (R-AL)
Olympia Snowe (R-ME)
Bob Smith (R-NH)
Gordon Smith (R-OR)
Ted Stevens (R-AK)
Fred Thompson (R-TN)
John Warner (R-VA)

May 30, 2001

Dear Senator __________________

The American Health Quality Association (AHQA) represents the national network of Medicare Peer Review Organizations (PROs). The PROs are required by federal statute to be independent, confidential, physician-led organizations with medical and statistical expertise. Having this expertise, they also work in many areas outside of Medicare. One of those areas is performing independent external appeals for private non-ERISA health plans and employers in many states across the nation.

On behalf of the PROs, we write in support of the independent external appeals procedures as they are drafted in Section 104 of the McCain/Kennedy/Edwards bill (S. 283). It has been reported that this legislation is likely to be considered by the Senate shortly upon returning from the Memorial Day Congressional Recess. We support this effort and urge you to pass this legislation.

Throughout this debate, AHQA has maintained that a strong independent external appeals process is the centerpiece of any worthwhile patients' rights legislation. Appeals should be performed by practicing physicians, must be handled quickly, and must be subject to expedited timeframes should the health of a patient be deteriorating. We believe Section 104 meets these criteria.

The PROs have great expertise in this area and under Section 104 they can become independent review entities in every state of the nation. This should help to assure the American public that experienced, state-based reviewers stand ready to hit the ground running from the moment the new law is implemented.

The PRO in your state that can become an independent external review entity is:

«PRO» Phone Number: «Phone»
«Address_1» Fax Number: «Fax»
«Address_2»    
«City», «State» «Zip»  

Thank you for your consideration of our position. If you have any questions, or would like additional information, please contact me.

Sincerely,
sylvia gaudette
Sylvia Gaudette
Director of Government Affairs
The American Health Quality Association


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