Summary of the Washington State Health Care Patient Bill of Rights

The Patient Bill of Rights takes effect July 2001, if funded.

Under the Bill, health care insurance plans are required to:

  1. provide an adequate choice of qualified doctors and other health-care providers. The plans must also make timely referrals to medical specialists.
  2. allow a patient to have repeat visits to a specialist (e.g. for cancer treatments) without the need to have a primary care physician (a gate-keeper) make a referral on each occasion.
  3. have a grievance process in place for handling claim disputes. Many plans already have a grievance/appeal procedure, however, the procedures will now be mandatory and the procedures will be applied with uniform rules.

Unfortunately, having rights is not the same thing as benefiting from those rights. If you are denied coverage and the health insurer is dragging its feet or requiring you to jump through hoops to get the care you or a loved one needs, you should seriously consider consulting a knowledgeable attorney. It is sad, but true, that an experienced attorney can sometimes successfully demand that a denial of coverage be reversed with a few telephone calls or letters. If not, the attorney can demand prompt compliance with appeal procedures, demand mediation or file a lawsuit. Because time is often critical, a call to an experienced attorney should not be put off.

Click here to read the Washington State Patient Bill of Rights.

Click here to read the Rules proposed by the Office of the Insurance Commissioner to implement the “Patient Bill of Rights” Ch. 5, Laws of 2000 (E2SSB 6199).