Children's Health Insurance Accountability Act of 1998

Summary

Children's Health Insurance Accountability Act of 1998 - Amends the Public Health Service Act to mandate that a group health plan or health insurance issuer provide to children of enrollees and enrollees who are children: (1) access to primary care providers who specialize in pediatrics and pediatric specialty services; (2) access to a sufficient number, distribution, and variety of qualified participating health care providers; (3) emergency services coverage without a requirement for either prior authorization determination, or a participating provider; (4) pediatric specialty services without imposing cost-sharing in excess of that required for other specialty care, and nonparticipating pediatric specialty services without additional cost; and (5) coverage that includes special consideration for the provision of services to children with special health care needs. (Sec. 3) Prescribes guidelines for continuity of care in the event that a contract between a health insurance issuer and a heath care provider should be terminated. Mandates that group health plans that cover children and health insurance issuers that offer health insurance coverage for children: (1) establish and maintain an ongoing, internal quality assurance program that meets certain requirements; (2) conduct utilization review activities that comply with prescribed criteria; (3) establish an internal and external appeals and grievance system meeting specified requirements; and (4) disseminate benefits and processes to the public plan. Requires group health plans and issuers of both group and individual health insurance plans to comply with the children's health accountability requirements set forth in this Act. (Sec. 3) (sic) Makes conforming amendments to the Employee Retirement Income Security Act of 1974. (Sec. 4) Directs the Secretary of Health and Human Services to study and report to the Congress on: (1) unique characteristics of patterns of illness, disability, and injury in children; (2) development of measures of quality of care and outcomes related to the health care of children; and (3) access of children to primary mental health services and the coordination of managed behavioral health services. Directs the General Accounting Office to study and report to certain congressional committees on: (1) the structure and performance of certain health plans (especially non-governmental plans) serving the needs of children with special health care needs; and (2) a survey of health plan activities that address the health needs of adolescents, including quality measures and innovative practice arrangement.

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Documents

3 official files

• Introduced in House (text)

  Introduced in House · EN · 23 June 1998

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• Introduced in House (PDF)

  Introduced in House · EN · 23 June 1998

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• Introduced in House

  summary · EN · 23 June 1998

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