To require that health care practitioners determine medically necessary and appropriate treatment and to require that insurers notify their enrollees of the extent of their coverage.
Health Care Consumer Protection Act of 1995 - Requires health insurers to provide notice regarding the extent of plan coverage to enrollees annually and to potential enrollees on request.
Requires that, under a health plan, the determination of what is medically necessary and appropriate for a patient be made only by a health care practitioner directly involved in the patient's care. Requires an insurer to pay for a service that is so determined if the service is covered by the plan. Mandates regulations to ensure against insurers offering monetary rewards, penalties, or inducements to a practitioner, or conditioning continued practitioner participation in the plan, on the basis of the practitioner's decisions to limit the availability of appropriate tests, services, or treatments.
Imposes a civil monetary penalty for violations of this Act.
Prohibits insurers from including provisions in a plan to hold itself harmless for liability.
Prohibits States from establishing or enforcing standards weaker than those of this Act.
Introduced in House
Introduced in House
Referred to the House Committee on Commerce.
Referred to the Subcommittee on Health and Environment.
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