Quality Health Care and Consumer Protection Act

Summary

Quality Health Care and Consumer Protection Act - Amends the Employee Retirement Income Security Act of 1974 and the Public Health Service Act (PHSA) to require managed care group health plans and managed care health insurance coverage to meet certain consumer protection requirements, including: (1) access to personnel and facilities; (2) assurance of adequate choice of health care professionals; (3) prohibition of gag rules; (4) coverage of drugs and devices; (5) coverage of experimental treatments; (6) quality assurance programs; (7) dissemination of certain plan information to all potential enrollees, as well as reporting of specified plan data to the Secretary and the public, subject to enrollee confidentiality; (8) disclosure of the plan medical director's financial arrangements; and (9) notice to enrollees of grievance procedures, reviews, and appeals. Amends PHSA to apply such managed care consumer protections to health insurance coverage offered by a health insurance issuer in the individual market in the same manner as it applies to health insurance coverage offered in connection with a group health plan.

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Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 21 March 1997

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• Introduced in House (PDF)

  Introduced in House · EN · 21 March 1997

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• Introduced in House

  summary · EN · 21 March 1997

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