Text: S03049                            Text: S03051
Text: S03000 - S03099                   Text: S Index
Bills and Amendments: General Index     Bill History: General Index

Senate Amendment 3050

Amendment Text

PAG LIN
  1  1    Amend Senate File 276 as follows:
  1  2    #1.  Page 11, by inserting after line 28 the
  1  3 following:
  1  4    "Sec.    .  NEW SECTION.  514K.1  HEALTH CARE PLAN
  1  5 DISCLOSURES – INFORMATION TO ENROLLEES.
  1  6    1.  A health maintenance organization, an organized
  1  7 delivery system, or an insurer using a preferred
  1  8 provider arrangement shall provide to each of its
  1  9 enrollees at the time of enrollment, and shall make
  1 10 available to each prospective enrollee upon request,
  1 11 written information as required by rules adopted by
  1 12 the commissioner and the director of public health.
  1 13 The information required by rule shall include, but
  1 14 not be limited to, all of the following:
  1 15    a.  A description of the plan's benefits and
  1 16 exclusions.
  1 17    b.  Enrollee cost-sharing requirements.
  1 18    c.  A list of participating providers.
  1 19    d.  Disclosure of the existence of any drug
  1 20 formularies used and, upon request, information about
  1 21 the specific drugs included in the formulary.
  1 22    e.  An explanation for accessing emergency care
  1 23 services.
  1 24    f.  Any policies addressing investigational or
  1 25 experimental treatments.
  1 26    g.  The methodologies used to compensate providers.
  1 27    h.  Performance measures as determined by the
  1 28 commissioner and the director.
  1 29    i.  Information on how to access internal and
  1 30 external grievance procedures.
  1 31    2.  The commissioner and the director shall
  1 32 annually publish a consumer guide providing a
  1 33 comparison by plan on performance measures, network
  1 34 composition, and other key information to enable
  1 35 consumers to better understand plan differences."
  1 36    #2.  By renumbering as necessary.  
  1 37 
  1 38 
  1 39                               
  1 40 ELAINE SZYMONIAK 
  1 41 
  1 42 
  1 43                               
  1 44 JOHN REDWINE 
  1 45 SF 276.703 78
  1 46 mj/sc

Text: S03049                            Text: S03051
Text: S03000 - S03099                   Text: S Index
Bills and Amendments: General Index     Bill History: General Index

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