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1999 SESSION

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SB 1299 Health insurance; standing referral for cancer pain management.

Introduced by: William C. Mims | all patrons    ...    notes | add to my profiles

SUMMARY AS PASSED: (all summaries)

Accident and sickness insurance; standing referral for cancer pain management. Requires each (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis, (ii) corporation providing individual or group accident and sickness subscription contracts, and (iii) health maintenance organization providing a health care plan for health care services, whose policies, contracts or plans, including any certificate or evidence of coverage issued in connection with such policies, contracts or plans to permit any individual covered thereunder who has been diagnosed with cancer to have a standing referral to a board-certified specialist in pain management or an oncologist who is authorized to provide services under such policy, contract or plan and has been selected by the cancer patient. The board-certified specialist in pain management or oncologist must consult on a regular basis as required under the terms of the policy, contract or plan, by telephone or through written communication, with the primary care physician and any oncologist providing care to the patient concerning the plan for pain management for the patient. The cancer pain management specialist is not be authorized to direct the patient to other health care services. Nothing contained in this provision will prohibit an insurer, corporation, or health maintenance organization from requiring a participating cancer pain specialist to provide written notification to the cancer patient’s primary care physician of any visit to him, which may include a description of the health care services rendered at the time of the visit. Insurers and health maintenance organizations subject to these provisions must inform subscribers in writing. These requirements will apply to all insurance policies, contracts, and plans delivered, issued for delivery, reissued, renewed, or extended or at any time when any term of any such policy, contract, or plan is changed or any premium adjustment is made and will not apply to short-term travel or accident-only policies, or to short-term nonrenewable policies of not more than six months' duration.


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