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Sample Letter to House Education & Workforce Committee on Health Plan Legal Accountability


Government Relations
Practice Directorate
July 1999
For more information: e-mail

Your Address

Date

The Honorable (Full Name)
United States House of Representatives
Washington, DC 20515

Dear Representative:

I am writing to urge you to vote for the Norwood amendment on health plan legal accountability as part of comprehensive managed care quality standards when the Education and the Workforce Committee debates managed care reform legislation.

As a result of a loophole in the Employee Retirement Income Security Act, most individuals and families enrolled in managed care plans are prohibited from bringing legal actions when they are injured as a result of negligent decisions by these plans to delay or deny treatment. The ERISA loophole allows plans to make negligent cost-containment decisions, including denials of covered benefits, without any accountability to the patient.

An external appeal, even when legally binding, will not protect patients from inappropriate cost-containment decisions. Health plans must be held accountable when they deny or delay a promised benefit and the patient is harmed as a result. Legal accountability will improve the care delivered in health plans and help patients to access necessary psychological services.

Thank you for consideration of my views.

Sincerely,




© 2008 American Psychological Association
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