Patient and Health Care Provider Protection Act of 1997

TABLE OF CONTENTS:

Title I: Health Plan Requirements

Title II: Office of Consumer Advocacy for Health

Title III: Independent Consumer Advisory Committees

Title IV: Coordination Among Office, Committees, and

Secretary

Patient and Health Care Provider Protection Act of 1997 - Title I: Health Plan Requirements - Prohibits a health plan, as part of any contract or agreement with a health care provider, from restricting any medical communication. Authorizes States to establish or enforce related requirements if they are more protective of a medical communication than that provided by this paragraph.

(Sec. 102) Prohibits a provider incentive plan unless it meets certain requirements of title XVIII (Medicare) of the Social Security Act.

(Sec. 103) Regulates plan denial of care.

(Sec. 104) Requires plans to take specified actions regarding the quality of care and protection of enrollee privacy rights.

(Sec. 106) Requires a health plan to pay the State an annual fee of one percent of the total amount of the annual premiums paid by State residents enrolled in the plan.

(Sec. 107) Imposes civil monetary penalties for violations of certain provisions of this title.

(Sec. 108) Prohibits plans from taking adverse actions against health care providers for certain actions, including those taken for the purpose of notifying a health plan of potentially dangerous conditions. Terminates Medicare participation and allows a private right of action for violations.

Title II: Office of Consumer Advocacy for Health - Directs the Secretary of Health and Human Services to establish for each State an independent office to assist consumers in dealing with plan and provider problems. Provides for a related grant. Requires each State to pay one percent of the annual premiums with respect to enrollment in a plan for individuals residing in the State.

Title III: Independent Consumer Advisory Committees - Requires each health plan to establish and maintain an Independent Consumer Advisory Committee in each community rating area to develop and coordinate outreach programs and ensure that enrollee grievances are addressed. Provides for Committee funding.

Title IV: Coordination Among Office, Committees, and Secretary - Requires an office to establish and maintain a system of referrals among the offices, other consumer advocacy organizations, legal assistance providers serving low-income persons, and protection and advocacy systems for individuals with disabilities.

(Sec. 402) Requires the offices to provide technical assistance to, and distribute and account for funding for, the Committees.