A bill to amend the Public Health Service Act and the Employee Retirement Income Security Act of 1974 to protect consumers in managed care plans and other health coverage.
Requires group health plans and health insurance issuers providing health insurance coverage to have approved utilization review programs, claims procedures, and appeal procedures concerning claims denials.
Sets forth provisions concerning group health plans and health insurers and the provision of certain advice and care, including: (1) emergency care; (2) obstetric and gynecological care; (3) specialists care; (4) prescription drugs; (5) participation in approved clinical trials; and (6) health plan information.
Sets forth nondiscrimination and other requirements regarding use of certain genetic information.
Restricts interference by health plans and insurers with the doctor-patient relationship.
Prohibits health plans and insurers from discriminating against a licensed health care professional with respect to participation or indemnification.
Sets forth limitations on certain class action litigation and other actions. Makes certain civil remedies available. Declares that courts should consider the loss of a nonwage earning spouse or parent as an economic loss to be fully compensated in certain ERISA cases.
Expresses the sense of the Senate that: (1) men and women battling life-threatening, deadly diseases, including advanced breast or ovarian cancer, should have the opportunity to participate in a federally approved or funded clinical trial; (2) a child battling a rare cancer should be allowed to go to a cancer center capable of providing high quality care for that disease; and (3) every patient who is denied care by a health maintenance organization or other health insurance company should have a fair, speedy, and impartial appeal to a review organization that has not been selected by the health plan.
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Introduced in Senate
Sponsor introductory remarks on measure. (CR S1293-1294)
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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