Second Opinion Coverage Act of 2005

Bill: 109-hr-2936
Sponsor: Rep. Davis, Susan A. [D-CA-53]
Introduced: 2005-06-16 in the House
Policy area: Health
Subjects: Administrative procedure
Coinsurance
Commerce
Communication in medicine
Consumer education
Department of Health and Human Services
Department of Labor
Department of the Treasury
Employee health benefits
Finance and Financial Sector
Government Operations and Politics
Health counseling
Health insurance
Labor and Employment
Law
Medical economics
Patients' rights
Physicians
Standards
Surgery

Summary:
action_date: 2005-06-16
text: 
Second Opinion Coverage Act of 2005 - Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code to require a group health plan and an issuer offering group coverage to provide coverage for second opinions upon request under certain circumstances, including if: (1) the participant questions the reasonableness or necessity of recommended surgical procedures or of a diagnosis or plan of care for a condition that threatens loss or substantial impairment of life, limb, or bodily function; (2) the clinical indications are not clear or are complex or confusing, a diagnosis is in doubt due to conflicting test results, or the treating health care professional is unable to diagnose the condition; (3) the treatment plan in progress is not improving the medical condition of the participant; and (4) the participant has attempted to follow the plan of care or has consulted with the initial provider concerning serious concerns about the diagnosis or plan of care. 
 
Applies such requirements to coverage offered in the individual market.
 


Legislative actions:
action_date: 2005-07-25
text: Referred to the Subcommittee on Employer-Employee Relations.
action_date: 2005-07-01
text: Referred to the Subcommittee on Health.
action_date: 2005-06-30
text: Referred to the Subcommittee on Health.
action_date: 2005-06-17
text: Sponsor introductory remarks on measure. (CR E1266-1267)
action_date: 2005-06-16
text: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
action_date: 2005-06-16
text: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
action_date: 2005-06-16
text: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
action_date: 2005-06-16
text: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
action_date: 2005-06-16
text: Introduced in House
action_date: 2005-06-16
text: Introduced in House