May 09, 2024

Warren, Marshall, Ruiz, Joyce, Porter, Murphy Introduce Bipartisan, Bicameral Bill to Restore Due Process Rights in Health Care

Bill Text (PDF)

Washington, D.C. – U.S. Senators Elizabeth Warren (D-Mass.) and Roger Marshall, M.D. (R-Kan.), along with Representatives Raul Ruiz, M.D. (D-Calif.) John Joyce, M.D. (R-Pa.), Katie Porter (D-Calif.), and Greg Murphy, M.D. (R-N.C.) introduced the Physician and Patient Safety Act to ensure due process rights for physicians. 

Federal law does not currently guarantee due process rights to physicians who are contracted, but not directly employed, by hospitals. Increasingly, private equity firms have acquired physician staffing agencies and applied pressure on physicians to prioritize profits over patients.  

This bill would ensure due process rights for physicians who are employed by third-party contractors or physician staffing companies, and ensure that physicians are able to uphold their commitment to practice medicine ethically and put their patients’ health and safety first – without fear of retaliation. 

“Physicians should never worry that raising alarms about patient safety could get them fired, but that’s exactly what happens when private equity and Wall Street buy up physician staffing agencies,” Senator Warren said. “It’s time to shield physicians from corporate greed so that they can provide the best care possible and keep patients safe.”

“Due process rights allow physicians to confidently advocate for their patients without the concern of facing termination,” Senator Marshall said. “Over time, these protections have gradually diminished across various departments, posing risks to patient safety. Our legislation aims to address this issue by closing loopholes, and enabling all physicians to uphold the integrity of the health care system.”

“As an emergency medicine physician, I have always placed the safety and well-being of our communities at the forefront,” Rep. Raul Ruiz, M.D. said. “I bring the same commitment to collaborative, bipartisan action in Congress, and that is why I introduced the Physician and Patient Safety Act. This bill is a crucial step towards ensuring that physicians can advocate for their patients without fear of losing their jobs. By extending due process rights to all physicians, we’re protecting the integrity of our health care system and making sure that physicians can focus on what they do best: providing top-of-the-line care to every patient who walks through their doors.”

“When doctors speak out against corporate greed that threatens patients, they should be safe from retaliation,” Rep. Katie Porter said. “I’m proud to support this bipartisan legislation that’ll help grant due process to doctors, so they can focus on keeping our communities healthy.”

The Physician and Patient Safety Act is supported by the American Academy of Emergency Medicine,  American Academy of Emergency Medicine Resident and Student Association, American College of Emergency Physicians, American College of Radiology, American College of Surgeons, American Medical Association, American Osteopathic Association, American Society of Anesthesiologists, Council of Residency Directors in Emergency Medicine, Free2Care, Kansas Chapter American College of Emergency Physicians, the Society for Academic Emergency Medicine, and AFT. 

“The Kansas Chapter of the American College of Emergency Physicians is proud to support Senators Marshall and Warren and Representatives Ruiz, Joyce, Murphy, and Porter in their support of practicing physicians nationwide. Protecting the rights of physicians is not just a matter of professional respect, but a cornerstone of patient safety and quality healthcare. The Physician and Patient Safety Act helps ensure that physicians facing potential termination, restriction, or reduction of their professional activity are granted due process rights. This upholds the integrity of medicine and fosters an environment of accountability and trust. It is a big step for both doctors and patients, safeguarding the pillars of our healthcare system.” said Howard Chang, MD FACEP FAAEM, President of the Kansas Chapter of the American College of Emergency Physicians.

“The American Academy of Emergency Medicine is proud to support Senators Marshall and Warren as well as Representatives Ruiz, Joyce, Murphy, and Porter in their introduction of legislation to ensure emergency physicians and all physicians have medical staff due process rights. There is no greater policy imperative for patient safety and quality care than enacting this due process legislation, which is a driving force of our organization’s mission statement,” said Robert Frolichstein, MD FAAEM FCCM, President of the American Academy of Emergency Medicine.

“The American Osteopathic Association is proud to support Senators Marshall and Warren and Representatives Ruiz, Joyce, Murphy, and Porter to ensure physicians practicing throughout the country have due process rights. Partnering with our patients is at the heart of osteopathic medicine, and this legislation is integral in enabling physicians to uphold their commitment to practicing medicine ethically, serving as their patient’s strongest advocates, and protecting the patient-physician relationship,” said Ira P. Monka, DO, FACOFP (Dist), President of the American Osteopathic Association.

“As the percentage of physicians working for hospitals and health systems is growing, it’s more important than ever to understand the challenges that employment presents to the medical profession and what principles should undergird physician employment. Due process is one of those fundamental principles for employed physicians, and this legislation would enshrine that principle. We commend the sponsors of this bill (Sens. Roger Marshall, M.D. R-Kan., and Elizabeth Warren, D-Mass., and Reps. Raul Ruiz, M.D., D-Calif., John Joyce, M.D., R-Penn, Katie Porter, D-Calif., and Greg Murphy, M.D., R-N.C.) for recognizing health care’s changing landscape,” said AMA President Jesse M. Ehrenfeld, M.D., MPH.

“Safeguarding the foundational right to due process for emergency physicians helps ensure that we can fully advocate for the health and well-being of our patients without fear of retaliation or termination. The ‘Physician and Patient Safety Act’ will help dismantle the current two-tiered system wherein many emergency physicians are not afforded due process protections like other physicians within the same hospital. ACEP is grateful for Senators Marshall and Warren and Representatives Ruiz, Joyce, Murphy, and Porter for their bipartisan leadership to ensure that those who provide our nation’s health care safety net can effectively advocate for our patients,” said Aisha Terry, MD, MPH, FACEP, President of the American College of Emergency Physicians (ACEP)

Senator Warren has led the fight against private equity in health care, consistently underscoring the harmful impacts on costs, employment conditions, quality of care, and patient and physician safety:

  • On May 1, 2024, at a hearing of the U.S. Senate Committee on Finance, Senator Warren questioned Andrew Witty, Chief Executive Officer for UnitedHealth Group, about  how the conglomerate leverages its market power to raise prices, increase payments it receives from Medicare Advantage through tactics like upcoding, and evade federal regulations that restrict insurance company profits.
  • On April 3, 2024, Senator Warren delivered remarks at a Senate hearing in Boston titled, “When Health Care Becomes Wealth Care: How Corporate Greed Puts Patient Care and Health Workers at Risk,” which centered on Steward Health Care’s Massachusetts hospitals.
  • On March 8, 2024, Senators Warren and Markey sent a letter to Dr. de la Torre, blasting him for years of financial mismanagement, private equity schemes, and executive profiteering that have led to Steward Health Care’s financial crisis.
  • On January 29, 2024, Senator Warren released a statement about Steward’s financial situation and allegations of patient neglect at Steward facilities.
  • On January 23, 2024, Senator Warren led the Massachusetts congressional delegation in a letter to the CEO of Steward Health Care pressing the company to brief them on Steward’s financial position, the status of their Massachusetts facilities, and their plans to ensure the communities they serve are not abandoned. 
  • On November 27, 2023, Senators Warren and Richard Blumenthal (D-Conn.) sent a letter to U.S. Anesthesia Partners and its private equity (PE) parent company Welsh, Carson, Anderson & Stowe raising concerns that PE’s involvement in health care markets has exacerbated problems like surprise medical billing, inadequate training, and lack of oversight and due process.
  • On November 16, 2023, Senators Warren, Bernie Sanders (I-Vt.), and Richard Blumenthal released a new report: Residents at Risk: Quality of Care Problems in Understaffed Nursing Homes and the Need for a New Federal Nursing Home Staffing Standard, revealing that, across a broad range of health outcomes, nursing homes with higher staffing levels that meet the requirements in the Centers for Medicare and Medicaid Services’ (CMS) proposed rule provide higher quality care than homes with lower staffing levels.
  • In May 2023, Senator Warren called out corporate owners of nursing homes, including private equity firms and Real Estate Investment Trusts (REITs), for their failures to protect patient safety and use of complex legal arrangements to avoid regulatory scrutiny.
  • In May 2022, Senator Warren and lawmakers sent a letter to private equity giant KKR regarding the grossly substandard care and unsafe living conditions in group homes it owned for people with intellectual and developmental disabilities. 
  • In February 2022, testifying before the Senate Budget Committee, Senator Warren called out private equity firms’ predatory practices of buying up distressed companies; stripping workers of benefits, fair pay, and safe working conditions, and reaping billions in profits. She noted that research shows that private equity ownership of nursing homes led to a 10% jump in short-term mortality rates.
  • In October 2021, Senator Warren and lawmakers reintroduced the Stop Wall Street Looting Act, a comprehensive bill to fundamentally reform the private equity industry and level the playing field by forcing private investment firms to take responsibility for the outcomes of companies they take over, empowering workers, and protecting investors. 
  • In October 2021, chairing a hearing of the Senate Banking, Housing, and Urban Affairs Subcommittee on Economic Policy, Senator Warren spoke about the need to protect companies and communities from destructive private equity practices as the industry’s growth continues to explode. 
  • In August 2021, Senator Warren and lawmakers launched an investigation into private equity ownership of for-profit hospice companies and subsequent reductions in the quality of care.
  • In November 2019, Senators Warren and Sherrod Brown (D-Ohio), and Representative Mark Pocan (D-Wisc.) wrote to four private equity firms that invested in companies providing nursing home care and other long-term care services, citing reports that show private equity investment has played a role in the declining quality of care in nursing homes and requesting information about each firms' management of this sector.

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