USE THIS LETTER AS A TEMPLATE TO SEND YOUR OWN PERSONALIZED MESSAGE TO YOUR REPRESENTATIVE AND SENATORS ON THE NEED FOR FEDERAL STANDARDS ON MANAGED CARE. CHANGE THE LETTER TO MAKE IT A PERSONAL STATEMENT FROM YOU. DO IT TODAY. THIS LETTER WAS SENT BY NASW TO THE WHOLE CONGRESS.
Dear Representative ------------------ or Senator -----------------------:
On behalf of the 155,000 members of the National Association of Social Workers (NASW), I am writing to urge your support for federal legislation that would establish federal managed care standards that can adequately protect consumers and health care professionals.
As a professional association of providers, most of whom work in health care settings, we believe strongly that quality and clinically appropriate care, not cost, must be the basis for decisions regarding health, mental health, and addictions’ treatment. Social workers and the public are looking to Congress for immediate relief from the chaos in our health system and fear of diminishing quality in our health services. Accordingly, I urge you to support such comprehensive managed care legislation as the Patient Access to Responsible Care Act (PARCA) (H.R. 1415/ S. 644) or other similar legislation.
In general, NASW supports the enactment of federal managed care standards that meet the following principles.
Quality: Managed care plans shall provide the highest quality care to all enrollees, with independently enforced standards to ensure appropriate quality health.
Information: Managed care plans shall provide consumers with accurate, complete and useful information, not gimmicks. Plans shall ensure that patient-specific health information remains confidential.
Affordability: Managed care plans shall provide health care that is affordable.
Choice: Managed care plans shall provide a choice of qualified health care professionals that represent a interdisciplinary mix of appropriately credentialed providers.
Access: Managed care plans shall provide timely access to appropriate care that meets the full range of health needs for the service population, including those with special needs.
Appropriateness: Managed care plans shall provide enrollees with a full choice of culturally appropriate benefits, providers, including facilities, and consumer information.
Consumer Rights: Managed care plans shall guarantee protection of basic consumer rights, including the right to an independent review of any decision to deny, reduce, limit or terminate care and access to an independent consumer ombuds program.
Public Accountability: Managed care plans shall be accountable to the public and guarantee effective enrollee participation in decision-making.
Eliminating Disincentives for Appropriate Care. Managed care plans shall eliminate financial and other practices that provide incentives for the denial, limitation or termination of appropriate care.
Community Benefits: Managed care plans shall be subject to effective independent consumer oversight and shall respond to community needs by reaching out to all constituencies, including underserved and special needs populations, and by improving overall community health.
Non-discrimination: Managed care plans shall not discriminate against any consumer or provider in their enrollment, quality, access or other practices.
I hope I can count on your support to enact meaningful legislation on managed care. Should you have any questions on PARCA or NASW’s managed care principles, please do not hesitate to contact Madeleine Golde, NASW Government Relations Staff Associate, at (202) 336-8237. Thank you.
Sincerely,
Josephine Nieves, MSW, PhD
Executive Director
For further information, contact mgolde@naswdc.org