SB 6199: Patient bill of rights

Summary

• $ Carriers offering health plans (including disability insurers, health care service contractors, health maintenance organizations, and state health plans) must comply with requirements regarding the privacy of an enrollee's health records; the disclosure of information about health plans to enrollees; access of enrollees to participating health providers of their choice, including specialists; and timely review of health care disputes through a grievance process.
• $ The Insurance Commissioner is required to establish a system for the review through an independent review organization of carrier decisions that deny, modify, reduce or terminate an enrollee's benefit coverage or payment. The Department of Health is required to certify qualified and impartial independent review organizations.
• $ An enrollee may bring a civil action against a carrier for damages for substantial harm proximately caused by its health care treatment under accepted standards of medical care. No enrollee may sue a carrier without first seeking redress through independent review.

From the Second Substitute House Bill Report (2SSB 6199), written by the Legislature's nonpartisan staff. Read the full report ↗