Senate Bill 225 Printer Number 1924

PENNSYLVANIA, September 21 – An Act to Amend the Act of May 17, 1921 (PL682, No. 284), known as the Insurance Companies Act of 1921, for Liability and Protection of Quality Health Care, further providing definitions, for responsibilities of managed care plans, for prohibition of financial incentives, for prohibition of medical gag clause, for emergency services, for continuity of care, for procedures, for confidentiality, for required disclosure and for the internal complaints process, providing for an internal complaints process for registrants, further providing for an appeal of complaints, for the resolution of complaints, for certification and for operational standards, providing for usage review standards, further providing for an internal grievance process, an external grievance process and records, providing for adverse determinations of a benefits, further providing for prompt payment of claims, for health care provider and managed care plan protection, for department powers and duties and for penalties standards and penalties, providing for regulations and further providing for compliance national accreditation standards and exceptions; make repeals; and make editorial changes.

Norman D. Briggs