FOR IMMEDIATE RELEASE Monday, August 10, 1998

CONTACT: Michael Orenstein (202) 606-1800 mworenst@opm.gov

President Clinton, OPM Ban Gag Clauses That Stifle Communication Between Doctors and Patients

Washington, D.C. -- President Clinton announced this morning in Louisville, Kentucky, that nine million people covered under the Federal Employees Health Benefits Program now are assured of receiving full and appropriate information on the vital health care treatment options available to them.

When the bottom line becomes more important than patients lives, when families have nowhere to turn when their loved ones are harmed by health care plans bad decisions, when specialist care is denied and emergency care is not covered even when they are plainly needed and recommended by physicians, we must act, President Clinton said. Whether in managed care or traditional care, every single American deserves quality care.

Final regulations issued today by the U.S. Office of Personnel Management prohibit the use of so-called gag clauses -- provisions or financial incentives contained in a health insurance carriers contract with health-care providers -- that can inhibit doctors, hospitals and other health-care providers from openly discussing medically-necessary treatment options with patients or which limit the delivery of needed medical services. Gag clauses sometimes are used by health insurance carriers to control medical costs but can have the unintended effect of compromising care.

The FEHB Program will always be a first-rate provider and pacesetter of medical care to Americas federal employees, retirees and their children, said OPM Director Janice Lachance, who participated in the Louisville event with the President. This action ensures the program remains a model that sets a proper standard for others.

OPMs ban on the use of gag clauses eases fears that financial considerations will win out over legitimate health concerns of federal employees, retirees and their families. The regulations apply to the 350 carriers participating in the Federal Employees Health Benefits (FEHB) Program.

In February 1998, President Clinton directed OPM to prohibit practices that restrict physician-patient communications about medically necessary treatment options. The presidential directive was an outgrowth of the Patient Bill of Rights which was designed to ensure that individuals covered by health plans are treated fairly by their insurance companies.

With the gag-clause ban, physicians and other health care providers will be able to talk freely with their patients, allowing them to practice good medicine while fulfilling sound medical-management practices.

It is imperative that patients know they are getting information about the most appropriate course of medical treatment for their condition without concern that bottom-line financial forces are working against them, said Director Lachance.

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