S. 1012 (109th): Patients’ Bill of Rights Act of 2005

May 12, 2005 (109th Congress, 2005–2006)
Died (Referred to Committee)
Edward “Ted” Kennedy
Senator from Massachusetts
Read Text »
Last Updated
May 12, 2005
233 pages
Related Bills
H.R. 2259 (identical)

Referred to Committee
Last Action: May 11, 2005

H.R. 2650 (Related)
Patient Protection Act of 2005

Referred to Committee
Last Action: May 26, 2005


This bill was introduced on May 12, 2005, in a previous session of Congress, but was not enacted.

Introduced May 12, 2005
Referred to Committee May 12, 2005
Full Title

A bill to amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to protect consumers in managed care plans and other health coverage


No summaries available.

Primary Source

THOMAS.gov (The Library of Congress)

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S. stands for Senate bill.

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GovTrack’s Bill Summary

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Library of Congress Summary

The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress.

Patients' Bill of Rights Act of 2005 - Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code to set forth requirements for health plans or issuers of health insurance coverage, including requirements for: (1) utilization review activities; (2) procedures for claims benefits processing, prior authorization determinations, appeals, and internal reviews; and (3) access for an independent, external review.
Requires the Secretary of Health and Human Services to establish the Health Care Consumer Assistance Fund to award grants to States for consumer assistance activities designed to provide information, assistance, and referrals to consumers of health insurance products.
Sets forth requirements for managed care programs and their access to care, including requiring such programs to: (1) offer coverage that allows for non-network coverage through another plan or issuer; (2) provide access to out-of-network emergency care without prior authorization; and (3) provide timely access to specialists.
Requires certain annual disclosures from health plans or issuers, including disclosures of covered benefits, cost-sharing requirements, and participating providers.
Prohibits a plan or issuer from: (1) restricting a health care professional's ability to advise a patient on the health of an individual or on medical care or treatment for the individual's condition or disease; and (2) operating any physician incentive plan.
Establishes a cause of action against a plan or issuer that fails to exercise ordinary care in making a decision that results in a personal injury or death to a participant or beneficiary.
Provides a tax credit to small businesses for expenses paid by the business for health insurance coverage of employees.

House Republican Conference Summary

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No summary available.

House Democratic Caucus Summary

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