On the recordSeptember 29, 1998
I concur with the sense of urgency that our colleague from Massachusetts just presented on this issue. With every day that goes by, another American family is at risk because they do not have these guaranteed protections; another American family is in a quandary because they do not have the kind of information that this would assure. The most contentious area between patients and their health maintenance organization is the emergency room. That is where the greatest number of disputes as to the appropriateness of service and responsibility for payment of service occurs. Recognizing that fact, last year, this Congress passed a very strong provision for the 35 million Americans who receive their health care financing through Medicare, to protect them relative to their HMO in an emergency room setting. Basically, the standard is, if you are a reasonable lay person and you are suffering from symptoms that a reasonable lay person would feel appropriate for emergency room treatment--say, you have a pain in your left chest--you can go to the emergency room, receive treatment, and not be faced a month later with an enormous bill from that same emergency room because the HMO denied coverage. The HMO is required to provide coverage.
Source
govinfo.gov




