The California Patient's Guide
Your Health Care Rights and Remedies
Prepared by Consumer Watchdog.

Made possible by a grant from The California Wellness Foundation and with the assistance of the California Dept. of Consumer Affairs and the California Dept. of Managed Health Care.


This guide is intended to inform you of your rights to receive quality health care and what steps you can take if you encounter problems. It has been assembled by medical, legal and consumer experts under the supervision of a non-profit organization, Consumer Watchdog, through a grant from the California Wellness Foundation.

While the authors of this guide have made every attempt to be as accurate and comprehensive as possible regarding current law, you should refer to the statutes and cases cited for the exact language used. You may wish to consult an attorney for assistance with how the law applies to your particular health care problem.

In recent years, state and federal legislators have responded to public concerns about threats to health care quality by enacting a number of new laws to help patients negotiate the managed health care system. This guide is current, to the extent possible, through the 2000 legislative session, including state laws signed by Governor Davis to be effective January 1, 2001.


You can download a PDF version of the printed guide in Spanish or English. (~370K)

English PDF

Spanish PDF

Acrobat Reader is required to view PDF files. You can download a free copy by clicking here.




If you have any questions contact:

calpatientguide@consumerwatchdog.org

Consumer Watchdog
1750 Ocean Park Blvd., Suite 200
Santa Monica, CA 90405

www.ConsumerWatchdog.org

310-392-0522
310-392-8874 fax

TABLE OF CONTENTS

Expanded Contents

Introduction

  1. Your Rights to Continuous Care, Second Opinions, Referrals and Information

  2. Your Right to Informed Consent

  3. Your Rights to Medical Records and Confidentiality

  4. Your Right to Emergency Medical Care

  5. Your Rights to Coverage of Pre-Existing Conditions

  6. Your Rights to File Grievances with your Health Plan and the Department of Managed Health Care

  7. Your Rights to Have your HMO's Decisions Independently Reviewed and to Sue Your HMO

  8. Your Rights to Appeal and Litigate Benefit Denials Under ERISA

  9. Health Care Coverage Options

Appendix A
Department of Managed Health Care's Consumer Complaint Form

Appendix B
Vital Steps to Receiving the Health Care You Need-A Checklist

Appendix C
Sample Letter

Appendix D
Strategic Advice For Patients: Tactics to Use and Understand

Appendix E
Useful Code Sections of the California Knox-Keene Health Care Service Plan Act of 1975 and Regulations

Glossary

Acknowledgements


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