Vote Smart's Synopsis:

Vote to table an amendment that would expand health care services for patients enrolled in managed care plans.

Highlights:

• Stipulates that women do not need a referral from their primary care provider to receive care from obstetricians and gynecologists.

• Requires insurers to provide emergency services to covered patients without prior authorization and whether or not the facility is a preferred provider.

• Requires that patients be granted access to specialists without a referral if their condition warrants it.

• Prohibits health insurers from discriminating against participants, enrollees, or beneficiaries.

• Calls for claims to be reviewed by external review boards and independent medical specialists to determine whether an insurer should have paid for a particular service and what reparations they may owe to the patient.

• Requires health care plans to follow the joint determination of doctor and patient on the period of time deemed necessary for a hospital stay following a mastectomy, lumpectomy or lymph node dissection for the treatment of breast cancer.

Full Bill Text

Full Bill Text