Bipartisan Consensus Managed Care Improvement Act of 1999

[AI summary unavailable — showing source text] Bipartisan Consensus Managed Care Improvement Act of 1999 - Title I: Improving Managed Care - Subtitle A: Grievances and Appeals - Requires a group health plan, and a health insurance issuer that provides health insurance coverage, to conduct utilization review activities that monitor or evaluate the use or coverage, clinical necessity, appropriateness, efficacy, or efficiency of health care services, procedures, or settings. (Sec. 102) Requires a plan and an issuer to provide appropriate notices to the participant, beneficiary, or enrollee for benefit claims it has denied that include reasons for denial and instructions for initiating specified internal appeals procedures, which must include procedures for an expedited review process in emergency situations. (Sec. 103) Outlines external appeals procedures for the timely resolution of certain denied claims through the use of qualified external appeal entities, which shall determine whether the plan's or issuer's decision is in accordance with the patient's medical needs. Declares that an external appeal entity's determination is binding on the plan and issuer involved. Provides for court-imposed civil monetary penalties and cease a…