The 12 patient rights in the Patients’ Bill of Rights come from a document the American Hospital Association approved on February 6, 1973, listing twelve principles hospitals were expected to honor.1American Hospital Association. Patient’s Bill of Rights No federal statute carries that exact title, but nearly all of the original twelve are now enforceable under federal regulations, most importantly 42 CFR 482.13, which every hospital that accepts Medicare or Medicaid must follow.2eCFR. 42 CFR 482.13 Condition of Participation – Patient’s Rights HIPAA, EMTALA, Section 1557 of the Affordable Care Act, and the No Surprises Act fill in the rest.
The AHA replaced the original document with something called “The Patient Care Partnership,” but the twelve principles it contained still shape state laws, federal rules, and individual hospital policies. Here is what each one means in practice, and the federal law that backs it up.
1. Clear Information and Informed Consent
You have the right to receive understandable information about your diagnosis, proposed treatments, and alternatives before agreeing to anything, including the expected benefits, risks, and side effects.2eCFR. 42 CFR 482.13 Condition of Participation – Patient’s Rights Informed consent is more than a signature on a form. Your provider has to explain the procedure in terms you understand, describe what could go wrong, and give you the chance to ask questions and say no. Courts have held providers liable when they skip that process.
Consent has limits on the provider’s side too. It doesn’t entitle you to demand treatments your care team considers medically unnecessary or inappropriate. And if you’re asked to join a clinical trial, federal rules require researchers to explain that the study is research, disclose foreseeable risks, tell you whether compensation or medical treatment is available if you’re injured, and make clear that participation is voluntary.3eCFR. 21 CFR Part 50 – Protection of Human Subjects
2. Participation in Treatment Decisions
You have the right to be actively involved in planning your own care. Federal regulations give you the right to help develop your care plan, be informed of your health status, and request or refuse treatment.2eCFR. 42 CFR 482.13 Condition of Participation – Patient’s Rights If you’re too sick to participate, a representative you’ve designated, or a family member allowed under state law, can step in.
Every Medicare-participating hospital must give you written information at admission about your right to create an advance directive, such as a living will or a durable power of attorney for health care.4Office of the Law Revision Counsel. 42 USC 1395cc – Agreements with Providers of Services A living will tells providers what treatments you do and don’t want if you can’t communicate. A durable power of attorney names someone to make decisions for you. Hospitals cannot condition your care on whether you’ve completed these documents, but they must ask and document your answer.
3. Privacy and Confidentiality
You have the right to personal privacy during your care and to have your health information kept confidential. HIPAA’s Privacy Rule protects all individually identifiable health information held by covered providers and health plans, whether stored electronically, on paper, or communicated verbally.5HHS.gov. Summary of the HIPAA Privacy Rule Your records and conversations about your care cannot be shared without permission unless a specific legal exception applies, such as mandatory disease reporting.
You can also ask your provider to communicate with you in a specific way, such as sending mail in a sealed envelope or calling a particular phone number for reminders. Covered providers must accommodate reasonable requests like these.
4. Respectful Care Without Discrimination
You are entitled to considerate and respectful treatment from every member of the healthcare team. Section 1557 of the Affordable Care Act prohibits discrimination in healthcare on the basis of race, color, national origin, sex, age, or disability, and “sex” has been interpreted to include pregnancy, sexual orientation, gender identity, and sex characteristics.6Federal Register. Nondiscrimination in Health Programs and Activities
If your primary language is not English, hospitals receiving federal funding must provide a qualified interpreter at no cost. They can’t ask you to bring your own or rely on your minor children to translate, except briefly in an emergency while locating a qualified interpreter.7HHS.gov. Language Access Provisions of the Final Rule Implementing Section 1557 of the Affordable Care Act A qualified interpreter must be proficient in both languages, interpret accurately and impartially, and follow confidentiality rules.
5. Refusing Treatment
A competent adult can refuse any medical treatment, including treatment needed to keep them alive. In Cruzan v. Director, Missouri Department of Health, the Supreme Court assumed that a competent person has a constitutionally protected right to refuse lifesaving hydration and nutrition.8Cornell Law School. Right to Refuse Medical Treatment Federal hospital rules reinforce this and require providers to inform you of the medical consequences of refusal.
There are narrow exceptions. State laws allow involuntary psychiatric holds when a person with a severe mental illness poses a significant risk of harm to themselves or others and no less restrictive option exists. Parents generally decide for minor children, though courts can override a parent’s refusal when a child’s life is at immediate risk.
6. Access to Your Medical Records
You have the right to see and get a copy of your protected health information from any covered provider, and to request corrections if something is inaccurate or incomplete.5HHS.gov. Summary of the HIPAA Privacy Rule
Providers can charge only for the actual cost of copying and postage. They can’t bill you for searching, retrieving, or maintaining the records. For electronic copies of records maintained electronically, providers can charge a flat fee of no more than $6.50 covering labor, supplies, and postage. If your records are already available through a patient portal’s download function, they can’t charge anything.9HHS.gov. Individuals’ Right Under HIPAA to Access Their Health Information
If you request an amendment, the provider must act within 60 days and can extend that by 30 days with written notice. A denial is allowed only on limited grounds: the information wasn’t created by that provider, isn’t part of your designated record set, wouldn’t be available for your inspection, or the provider determines the existing information is already accurate and complete. A denial must be in writing, and you have the right to submit a written statement of disagreement that becomes part of your record.10eCFR. 45 CFR 164.526 – Amendment of Protected Health Information
7. A Second Opinion
You have the right to seek a second opinion about your diagnosis or treatment plan. No federal law prohibits it, and Medicare specifically covers second opinions when a doctor recommends surgery or a major procedure. Medicare will even cover a third opinion if the first two doctors disagree. Your original provider cannot penalize you or refuse continued care because you consulted someone else.
8. Pain Management
Healthcare facilities are expected to assess and manage your pain as part of quality care. There is no single federal statute titled “right to pain management,” but hospital accreditation standards and CMS guidelines treat pain assessment as an integral component of patient care. Your providers should ask about your pain, take your reports seriously, and work with you on a management plan. You can raise concerns if you feel your pain is being ignored or undertreated.
9. Continuity of Care
Your care should not be abruptly cut off. If your health plan or insurer terminates its contract with your provider while you’re in the middle of an ongoing course of treatment, 42 USC 300gg-113 requires your plan to notify you and give you the option to continue care from that provider under the same terms for up to 90 days.11Office of the Law Revision Counsel. 42 USC 300gg-113 – Continuity of Care This applies to group health plans, individual insurance, and situations where a provider’s participation ends for any reason while you’re a continuing care patient.
10. Knowing Hospital Rules and Charges
You have the right to be informed of hospital policies that affect your care, including visiting hours, patient responsibilities, and billing practices. Federal price transparency rules go much further than the original AHA principles. Since January 2021, every hospital in the United States must publish its standard charges online in two formats: a comprehensive machine-readable file listing all items and services, and a consumer-friendly display of common shoppable services.12eCFR. 45 CFR Part 180 – Hospital Price Transparency
Pricing data must include the gross charge, discounted cash price, payer-specific negotiated rates broken down by insurer and plan, and the minimum and maximum negotiated charges. All of it must be free to access, with no login or registration required.13CMS. Hospital Price Transparency Hospitals that don’t comply face civil monetary penalties.
11. Filing a Complaint or Grievance
If something goes wrong, you have the right to voice a complaint and receive a response. Federal regulations require every Medicare-participating hospital to establish a clearly explained grievance process, tell you whom to contact, and set specific timeframes for reviewing and responding.2eCFR. 42 CFR 482.13 Condition of Participation – Patient’s Rights
The hospital’s governing body is ultimately responsible for the grievance process, though it can delegate to a committee. When your complaint is resolved, you must receive a written notice with the contact person’s name, the steps taken to investigate, the outcome, and the completion date. The process must also include a way to refer quality-of-care concerns or premature discharge disputes to the appropriate Quality Improvement Organization, an independent body that reviews such issues.
12. Discharge Planning
Before you leave the hospital, you have the right to a discharge plan that prepares you for what comes next. Federal regulations require hospitals to have a discharge planning process that focuses on your goals, includes you and your caregivers as active partners, and ensures a smooth transition to post-discharge care.14eCFR. 42 CFR 482.43 – Condition of Participation: Discharge Planning
The hospital must identify patients who would face health risks without adequate discharge planning early in the stay. Your discharge evaluation should assess your likely needs for post-hospital services, such as home health care, skilled nursing, or hospice. The results must be discussed with you and included in your medical record. When you’re referred for home health or transferred to a skilled nursing facility, the hospital must provide a list of available Medicare-participating facilities in your area so you have real choices.
If you’re a Medicare patient and think you’re being discharged too soon, you can request a fast appeal through the Beneficiary and Family Centered Care Quality Improvement Organization. You should get an “Important Message from Medicare” within two days of admission explaining how. If you file the appeal before your scheduled discharge date, you can stay in the hospital while the review is pending without paying for the additional days beyond your normal cost-sharing.15Medicare.gov. Fast Appeals
Rights Federal Law Added After the Original Twelve
Two federal laws now give you protections the AHA’s 1973 document didn’t cover but that patients often assume are part of it.
Emergency Care Regardless of Ability to Pay
The Emergency Medical Treatment and Labor Act, enacted in 1986, requires any hospital with an emergency department to give a medical screening examination to anyone who shows up requesting treatment for an emergency, regardless of insurance status or ability to pay.16Office of the Law Revision Counsel. 42 USC 1395dd – Examination and Treatment for Emergency Medical Conditions and Women in Labor If the screening reveals an emergency medical condition, including active labor, the hospital must stabilize you using its available staff and facilities or transfer you to another facility that can. Transfers of unstable patients are tightly restricted.
Protection Against Surprise Medical Bills
The No Surprises Act, in effect since 2022, protects you from surprise bills when you had no meaningful choice of provider. With private insurance, you cannot be balance-billed more than your plan’s in-network cost-sharing amount for emergency care, no matter whether the hospital or doctor is in your plan’s network. The same protection applies when you get care from an out-of-network provider at an in-network facility for non-emergency services, like an out-of-network anesthesiologist assigned to your in-network surgery.17Office of the Law Revision Counsel. 42 USC 300gg-111 – Preventing Surprise Medical Bills Your cost-sharing is calculated as if the provider were in-network and counts toward your in-network deductible and out-of-pocket maximum. The provider and insurer settle the rest between themselves.
If you’re uninsured or paying out of pocket, providers must give you a good faith estimate of expected charges before scheduled care.18eCFR. 45 CFR 149.610 – Requirements for Provision of Good Faith Estimates If the final bill exceeds the estimate by $400 or more, you can challenge it through a federal patient-provider dispute resolution process.
How to Enforce These Rights
Knowing your rights matters only if you can act on them. Start with the hospital. Every Medicare-participating hospital must have a grievance process, and most have patient advocates or ombudsmen who can intervene while you’re still receiving care.
For privacy violations, file a complaint with the HHS Office for Civil Rights within 180 days of when the violation occurred or when you learned about it.19HHS Office for Civil Rights. Complaint Portal For quality of care or premature discharge concerns, contact your regional Quality Improvement Organization, which is federally contracted to review these complaints independently. For EMTALA violations, such as being turned away from an emergency department or transferred while unstable, report it to CMS.20CMS. Emergency Medical Treatment and Labor Act (EMTALA) For surprise billing disputes, the No Surprises Act has its own federal dispute resolution path. For discrimination complaints under Section 1557, the Office for Civil Rights handles those too.
You don’t need a lawyer to file any of these initial complaints. They’re administrative processes designed for patients to use directly, and the agencies involved have enforcement authority that facilities take seriously.