Sponsor Statement for HB 359

This bill is offered to impose requirements on managed care providers to enhance patient care, including advocacy of patient care and prohibiting financial incentives to withhold health care.

Requires insurer to disclose terms and conditions of the health insurance plan upon enrollment, annually and upon request. This information shall provide for but not be limited to a current provider directory and referral information.

Provides for a designated medical director and imposes his/her duties and responsibilities and provides for the establishment of a notice and hearing procedure for the termination of a health care provider.

Requires the option to allow covered persons to receive health care from any non-participating health care provider.

Establishes an appeals board to review decisions by an insurer to reduce, deny or terminate benefits and requires written decisions.