98RS SB315


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SB 315/FN (BR 1706) - E. Scorsone, B. Bailey, W. Blevins, F. Bradley, D. Karem, G. Neal

     AN ACT relating to health care.
     Create new sections in the insurance code, KRS Chapter 304, to establish the Health Consumer Protections and Responsibilities Act; require health insurers to disclose a general summary of all covered benefits and types of dispute resolution procedures; require insurers that offer a managed care plan to disclose information on primary care providers and specialists, provider compensation methods, rules for out-of-network services, and access to urgent care centers, names of contracting health care facilities, preauthorization and utilization requirements, use of clinical protocols, special disease programs, whether a drug is included in a formulary, and qualifications of reviewers at the primary and appeal levels; require access to sufficient number of primary care providers; require that qualified health care providers be available to women to provide routine and preventative women's health services; require direct access to specialists for persons with complex or serious medical conditions; require continuity of care from specialty health care providers; require plans to educate insureds about availability of and appropriate use of emergency care; require plans to cover emergency department screening and stabilization services; require plans to provide patients with easily understood information, and the opportunity to decide among treatment options; prohibit discrimination against consumers of health services and applicants for coverage based on race, ethnicity, national origin, religion, sex, age, mental or physical disability, genetic information, or source of payment; require health care providers to provide consumers with considerate, respectful care at all times and under all circumstances; provide that consumers have to right to communicate with health care providers in confidence and have the confidentiality of their individually identifiable health care information protected; provide that all insureds have the right to a fair and efficient process for resolving differences with their health plans and providers; and establish responsibilities of consumers of health care services.

     Feb 17-introduced in Senate
     Feb 18-to Health and Welfare (S)

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