Patients’ Right to Freedom of Choice of Providers: Complaint by Provider against Hospital Substantiated by State Surveyors
©2021 Elizabeth E. Hogue, Esq. All rights reserved.
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Providers must have a steady stream of referrals in order to be viable. By the same token, all patients have the right to choose the providers who render care to them.
Several sources affirm the right of patients to choose their providers, including the following:
- Court decisions establish the right of patients to control the treatment they receive, including the right to determine who provides care. Thus, one source of patients’ right to freedom of choice of providers is the so-called “common law.” The right of freedom of choice of providers based upon the common law applies to all patients, regardless of treatment setting or payor source.
- Federal statutes of both the Medicare and Medicaid Programs guarantee patients whose care is paid for by these Programs the right to freedom of choice of providers, regardless of treatment setting.
- The Balanced Budget Act of 1997 and Conditions of Participation (COP’s) of the Medicare Program require hospitals only to develop a list of home health agencies that: (1) are Medicare-certified, (2) provide services in the geographic area in which patients reside, and (3) ask to be on the list. In addition, if hospitals have a financial interest in a home health agency that is included on the list, the hospital’s financial interest must be disclosed on the list. This list must be presented to patients discharged from hospitals who receive home health services.
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