HR 3547 · 105th Congress · Health

Patient Choice and Access to Quality Health Care Act of 1998

Introduced 1998-03-25· Sponsored by Rep. Weldon, Dave [R-FL-15]· House

Bill Progress

Introduced
2
Committee
3
House Vote
4
Senate
5
Enacted
Latest: Referred to the Subcommittee on Employer-Employee Relations.(1998-04-17)

Plain Language Summary

[AI summary unavailable — showing source text] Patient Choice and Access to Quality Health Care Act of 1998 - Amends the Public Health Service Act (PHSA) to establish additional protections for enrollees in group health plans. (Sec. 3) Requires any group health plan, and any health insurance issuer offering group health insurance coverage, that restricts the health care professionals from whom benefits may be obtained to guarantee enrollees timely access to primary and specialty health care professionals appropriate to the enrollee's condition, including specialized treatment when medically necessary, and specialists for ongoing care. Declares that a plan's or issuer's use of case management may not create an undue burden for enrollees. Requires plans and issuers to provide: (1) a meaningful and expedited procedure for resolving enrollee grievances; and (2) timely notice of any denial of services in-network or denial of payment for out-of-network care. Requires plans and issuers to establish a board of appeals to hear and make determinations on enrollee complaints. Requires plans and issuers to provide each enrollee, at the time of enrollment and annually, an explanation of enrollees' rights and a copy of the most recent enroll…

Summarized by Claude AI · Non-partisan · For informational purposes only

Cosponsors (11)

7 Democrats3 Republicans1 Independent