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Date: Monday, Dec. 9, 1996
FOR IMMEDIATE RELEASE
Contact: HCFA Press Office(202) 690-6145

HCFA Assures Medicare Beneficiaries of Rights to Advice from Physicians

 Medicare managed care plans may not prevent physicians from providing information to patients regarding all medically necessary treatment options, the Health Care Financing Administration (HCFA) said today.

In a letter to more than 300 managed care plans contracting with Medicare, HCFA said that contract clauses limiting what physicians may tell Medicare beneficiaries violate federal law.

"No beneficiary should be denied the information they need to make a sound, informed decision on their treatment," said HHS Secretary Donna E. Shalala. "Patients and their doctors must have a free exchange of information."

Many managed care organizations in recent months have agreed that "gag clauses" limiting discussion of medically necessary treatments should not exist. President Clinton has endorsed federal legislation that would make such clauses illegal. Enactment of such legislation is an administration priority.

HCFA's action today applies to more than 4.7 million Medicare beneficiaries enrolled in managed care plans. An average of 80,000 beneficiaries enroll in such plans each month.

"HCFA will be vigilant in assuring that no contract clauses limit what physicians can say to their patients," said HCFA Administrator Bruce C.Vladeck. HCFA is working on a similar policy clarification for state Medicaid programs.

Note: HHS press releases are available on the World Wide Web at: www.hhs.gov.