PlainBillCongress, translated.Legislation. Context. Public interest.Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S5075-5099)
Congressional Research Service
Version 00 · Introduced in Senate · May 12, 2005
Patients' Bill of Rights Act of 2005 - Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code to set forth requirements for health plans or issuers of health insurance coverage, including requirements for: (1) utilization review activities; (2) procedures for claims benefits processing, prior authorization determinations, appeals, and internal reviews; and (3) access for an independent, external review.
Requires the Secretary of Health and Human Services to establish the Health Care Consumer Assistance Fund to award grants to States for consumer assistance activities designed to provide information, assistance, and referrals to consumers of health insurance products.
Sets forth requirements for managed care programs and their access to care, including requiring such programs to: (1) offer coverage that allows for non-network coverage through another plan or issuer; (2) provide access to out-of-network emergency care without prior authorization; and (3) provide timely access to specialists.
Showing the opening paragraphs of the official summary.
Requires certain annual disclosures from health plans or issuers, including disclosures of covered benefits, cost-sharing requirements, and participating providers.
Prohibits a plan or issuer from: (1) restricting a health care professional's ability to advise a patient on the health of an individual or on medical care or treatment for the individual's condition or disease; and (2) operating any physician incentive plan.
Establishes a cause of action against a plan or issuer that fails to exercise ordinary care in making a decision that results in a personal injury or death to a participant or beneficiary.
Provides a tax credit to small businesses for expenses paid by the business for health insurance coverage of employees.
People & committees
Sen. Kennedy, Edward M. [D-MA] · D–MA
Legislative record
A procedural vote is different from passage. Passage in one chamber does not establish enactment. Explore the glossary.
Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S5075-5099)
Sponsor introductory remarks on measure. (CR S5075)
Introduced in Senate
Primary sources
Text links open the official source. We currently store references to these documents.
Source last updated: Dec 11, 2025. Consult Congress.gov for the current record.
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