Summary
Patient Bill of Rights Act of 2004 - Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code to apply patient protection and quality care standards to group health plans and issuers of health insurance coverage. Applies such standards also to Federal health insurance programs.
Requires such plans and issuers to have approved utilization review programs, claims procedures, and appeal procedures concerning claims denials.
Requires patient access to health plan information and to care, including: (1) a consumer choice option and choice of health care professional; (2) emergency care; (3) timely access to specialists; (4) obstetrics, gynecology, and pediatrics; (5) care continuity; (6) prescription drugs; (7) participation in clinical trials; and (8) breast cancer treatment hospital stays and consultations.
Restricts interference by a plan or insurer with the doctor-patient relationship. Prohibits discrimination against a licensed health care professional with respect to participation or indemnification. Sets forth requirements relating to payment of claims and protection of patient advocacy.
Provides a tax credit for the health insurance expenses of small businesses. Treats qualified health benefit purchasing distributions by private foundations as distributions for a charitable purpose.
Establishes demonstration grants programs to: (1) increase access to health insurance through alternative means; and (2) provide health insurance information to small employers.
Lifecycle of the Bill
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