The delivery of quality, accessible and affordable health care to the citizens of Maryland is one of the most important concerns facing this state as we approach a new millennium. During these rapidly changing times, our citizens have become increasingly frustrated with the ability of the health care industry to deliver the medical services they believe are necessary to maintain their quality of life. The state’s health care system is undergoing significant change, and many citizens worry that these changes reduce their health options and lessen their quality of care. There is growing criticism that medical care decisions are being driven by concerns about holding down costs at the expense of basic health care.

The Rehrmann Health Plan for Maryland includes four important principles:

The Rehrmann HMO Patient’s Bill of Rights has a set of principles that addresses dignity and respect, access to heath care, privacy and confidentiality, communications and grievances, financial information and disclosure.

Every patient in an HMO should be guaranteed the right to receive quality health care from qualified, responsible physicians, health care facilities and other health care providers. In Maryland, there are strong standards of accountability for physicians but not for directors of managed care programs. The medical directors of HMOs should be subjected to the authority of the Board of Physician Quality Assurance, the same as physicians.

To improve efficiency, Maryland needs to integrate, streamline and consolidate certain health care regulatory responsibilities and duties, similar to House Bill 2, which failed in the closing moments of last year’s legislative session.

A CONSUMER ASSISTANCE PROGRAM

Maryland needs a Consumers Assistance Program, housed as a special unit with the Department of Health and Mental Hygiene, to help educate newcomers to managed care and provide advocacy and information for those having problems navigating managed care systems.

The Rehrmann plan is a collaborative effort to promote the interests and well-being of the patients and to promote better communications between these patients and their health care providers. 

• A patient has the right to emergency services if they feel their health is in serious jeopardy.

• A patient has the right to have a primary care provider or back up, 24 hours a day, 365 days a year for urgent care.

• A patient has the right to continuity of care, for a minimum of 90 days, including seriously ill patients and pregnant women, who are forced to change insurance plans to allow for transition of care.

• A patient has the right not to be excluded from enrolling in a health insurance program to due a pre-existing condition.

• A patient has the right to guaranteed access to an appropriate medical specialist, when necessary, including a woman’s right to an obstetrician/gynecologist.

• A patient has the right to standing referrals when they must see a specialist frequently.

• A patient has the right to select and receive outside care if a plan does not have a doctor with appropriate expertise within their plan.

• A patient has the right to have a doctor make treatment recommendations, not an administrator.

• A patient has the right to no "gag rules" and doctors can discuss all treatment options even if they are not covered services or expensive.

• A patient has the right to have their health care information used for health care purposes only and not sold to a third party.

• A patient has the right to informed consent, participation in treatment decisions and the right to be excluded from medical research.

• A patient has the right to be informed if any part of the bill will not be covered by insurance.

• A patient has the right to receive a copy of health care provider rates, and itemized bill and an explanation of any relevant questions upon request.

• A patient has the right to retain comparable coverage at the same price until the expiration date of their insurance policy, except where the premiums are not paid.

• A patient has the right to express grievances to a provider's board of appeals or to the appropriate state agency.

• A patient has the right of access to his or her medical records without delay or unreasonable expense.

• A patient has the right to be given complete, current information regarding policy, diagnosis, treatment and prognosis in terms the patient can reasonably be expected to understand.

• A patient has the right to communication assistance and translation/interpreter services.

• A patient has the right to receive their doctor’s recommendations and referrals for medical alternatives, specialists, prescription drugs, therapy and equipment.