Note: The information provided on this website is not legal advice, but for general information only. This article may not be the most up-to-date legal or policy information. For the best information, follow the links to government websites.
Patients Rights Basics
A number of state and federal laws have passed over the years offering some protections to healthcare consumers. Laws cover privacy of sensitive medical information, required access to and parity for certain types of care, affordability, surprise bills, nondiscrimination, rights to continue employer coverage in some circumstances, and grievance policies. Connecticut healthcare facilities also offer Patient Bills of Rights, available online.
Most of these protections only apply in specific circumstances. This is not to suggest that available protections are sufficient or that there is not significant room to improve patients’ rights.
Patients Rights Deeper Dive
A look at the federal laws that protect patients’ rights in chronological order.
Employee Retirement Income Security Act (1974)
The Employee Retirement Income Security Act (ERISA) is a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry. The law addresses plan information to members, grievance and appeal processes, standards for participation and financial management of the plans. ERISA applies to all plans, including employer-funded plans that aren’t subject to state oversight.
Emergency Medical Treatment and Active Labor Act (1986)
The Emergency Medical Treatment and Active Labor Act (EMATALA) protects access to emergency services regardless of ability to pay. It is commonly referred to as a federal “anti-dumping law” that prevents hospitals from denying or limiting treatment to patients based on their insurance status or ability to pay, or to transfer them to other facilities until they are stabilized.
Consolidated Omnibus Budget Reconciliation Act (COBRA) (1986)
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives most workers and their families who lose their health benefits the ability to choose to continue group health benefits provided by their group health plan. However, the coverage is often very expensive.
Health Insurance Portability and Accountability Act (HIPAA) (1996)
The Health Insurance Portability and Accountability Act (HIPAA) creates national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge. Some states have passed updated privacy protections that reflect innovations like electronic health records and new risks such as breaches. See Connecticut laws in the below section.
Newborns’ and Mothers’ Health Protection Act (1996)
The Newborns’ and Mothers’ Health Protection Act (NMHPA) affects the length of time a mother and newborn child are covered for a hospital stay in connection with childbirth.
The Women’s Health and Cancer Rights Act (1998)
The Women’s Health and Cancer Rights Act (WHCRA) provides protections to patients who choose to have breast reconstruction in connection with a mastectomy.
Mental Health Parity and Addiction Equity Act (2008)
The Mental Health Parity and Addiction Equity Act (MHPAEA) generally prevents large health insurance plans that provide mental health and substance use disorder (MH/SUD) benefits from imposing less generous benefits on services for those disorders than on medical/surgical coverage.
Genetic Information Nondiscrimination Act (GINA) (2008)
The Genetic Information Nondiscrimination Act (GINA) protects individuals against discrimination based on their genetic information in health coverage and in employment.
Patient Protection and Affordable Care Act (2010)
The Patient Protection and Affordable Care Act (ACA), includes many new rights and protections to make affordable health coverage available to more Americans, sets standards for what services must be covered, makes plan information understandable, improves the quality of care, and the improve public’s health.
No Surprises Act of the Consolidated Appropriations Act (2021)
The No Surprises Act protects people covered under health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers.
Hospital Price Transparency Rule & Health Plan Transparency Rule (2021)
The Inflation Reduction Act (2022)
The Inflation Reduction Act lowers drug prices for Medicare, through negotiation, limits Medicare beneficiaries’ out-of-pocket costs to $2,000 per year, and continues COVID subsidies that lower health insurance premiums in ACA exchanges.
Connecticut State Laws
Connecticut state laws include patient protections concerning facility fees, surprise bills, and other protections. For more information, contact the Connecticut Office of the Healthcare Advocate.
Connecticut Local Facility Bill of Rights
In addition to federal and state laws some facilities in Connecticut have created bills of rights that provide additional protections and rights in their facility.
U.S. Department of Health and Human Services
Office of the Healthcare Advocate (Connecticut)
Connecticut’s Program for Health Insurance Assistance, Outreach, Information and Referral, Counseling, Eligibility Screening (CHOICES)- State Health Insurance Assistance Program
Written by Scott Schere