Requires plans to offer policyholders the option of an expedited arbitration process in addition to internal review. Provides that plans that follow such review procedures and do not act negligently when following such review procedures shall not be subject to civil liability for such decisions.
Capital letters indicate new material to be added to existing statute.
Dashes through the words indicate material to be deleted from existing statute. Establishes that carriers operating managed care plans have a duty to act with reasonable care when making decisions involving the exercise of discretion by the plan affecting the provision of health care services, including but not limited to decisions regarding experimental treatments and may be liable for damages for harm to a covered person proximately caused by the carrier's or managed care plan's negligent acts. Provides affirmative defenses to any action filed alleging negligence of a carrier. Specifies that such duty does not create any obligation on the part of a carrier providing coverage through a managed care plan to provide to a covered person treatment that is not covered by the plan. Prohibits carriers entering into contracts with health care providers from including in such contracts an indemnification or hold harmless clause for the acts or conduct of the carrier or managed care plan and declares such clauses void as against public policy.