Second Opinion Coverage Act
Madam Speaker, today, I am introducing the Second Opinion Coverage Act--legislation that will ensure the accessibility and coverage of medical second opinions. Imagine that your doctor tells you that you must undergo radical surgery that…
Madam Speaker, today, I am introducing the Second Opinion Coverage Act--legislation that will ensure the accessibility and coverage of medical second opinions.
Imagine that your doctor tells you that you must undergo radical surgery that may threaten the use of a limb or leave you with a serious chronic condition. Understandably, you would request a second opinion from another physician. Most health care groups see the value in such requests and provide patients with a second opinion. Besides giving patients much needed peace of mind, second opinions can benefit health plans by reducing the number of invasive procedures and result in better patient care through increased dialogue about treatment options.
However, when I was a member of the California State Assembly, I heard from a number of patients who experienced a glitch in their health care coverage. They noticed the absence of a clear process for obtaining medical second opinions. These patients, many struggling with challenging health conditions, had difficulties obtaining second opinions through their health plans.
After meeting with patients, physicians and health groups, I authored a law in California that guarantees coverage of second opinions. Patients, meeting any one of several qualifying conditions, are entitled to a timely second opinion by a ``qualified health care professional,'' within 72 hours in cases of serious or imminent health threat. When another expert is not available within the provider group or network, the organization will pay for an appropriately qualified doctor outside of the plan. Patients are responsible for the costs of applicable co-payments.
The law in California was a good first step. Unfortunately, this legislation does not cover individuals enrolled in self-insured, federally regulated health plans. Nationwide, this translates into 67 million persons without guaranteed access to second opinions. I believe the time has come to make access to second opinions a national standard.
I urge you, Madam Speaker, and all of my colleagues to pass this critical legislation into law.