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Requires group health plans and health insurance issuers providing health insurance coverage to have approved utilization review programs, claims procedures, and appeal procedures concerning claims denials.
Sets forth provisions concerning group health plans and health insurers and the provision of certain advice and care, including: (1) emergency care; (2) obstetric and gynecological care; (3) specialists care; (4) prescription drugs; (5) participation in approved clinical trials; and (6) health plan information.
Restricts interference by health plans and insurers with the doctor-patient relationship.
Prohibits health plans and insurers from discriminating against a licensed health care professional with respect to participation or indemnification.
Expresses the sense of Congress that: (1) men and women battling life-threatening, deadly diseases, including advanced breast or ovarian cancer, should have the opportunity to participate in a federally approved or funded clinical trial; (2) a child battling a rare cancer should be allowed to go to a cancer center capable of providing high quality care for that disease; and (3) every patient who is denied care by a health maintenance organization or other health insurance company should have a fair, speedy and impartial appeal to a review organization that has not been selected by the health plan.
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No CBO cost estimate has been published for this bill.