Bipartisan Patient Protection Act

Summary

Bipartisan Patient Protection Act - Imposes utilization review requirements on group health plans and health insurance issuers. Establishes a claims denial right to internal and external appeal. Makes a claim eligible for independent medical review if it was denied because the item or service is not medically necessary and appropriate, is experimental or investigational, or is not covered based on other grounds that require evaluation of the medical facts by a health care professional. Requires access to care, including non-network providers, timely access to specialty care, direct access to specialists in obstetrics and gynecology, investigational drug and device coverage, coverage for patients in clinical trials, and the inpatient period for breast cancer patients. Prohibits restricting a health care professional's communications with a patient, discrimination against a provider solely because of the provider's license or certification, improper incentives, and retaliation for patient advocacy, including by providers. Requires prompt claims payment. Requires issuers offering individual coverage, and plans and issuers under the Employee Retirement Income Security Act of 1974, to comply with this Act. Makes a plan or issuer liable for economic and noneconomic damages for failing to exercise ordinary care in making a decision that is not eligible for independent medical review. Shields an employer or other plan sponsor from that liability unless it directly participated in the decision. Allows up to $5 million in penalties if the claimant demonstrates that the defendant's conduct demonstrated bad faith and flagrant disregard for the participant's or beneficiary's rights. Prohibits actions under specified provisions of this Act from being class actions. Mandates transfer of Federal revenues to ensure that the income and balances of Social Security Act trust funds are not reduced as a result of this Act's enactment. Extends the termination date of provisions imposing fees on certain customs services. Delays the required submission date of a letter of credit by carriers administering Supplementary Medical Insurance.

This text is taken from the official record. PoliticalRepo does not editorialize.

Timeline

No timeline events have been ingested for this record yet.

Votes

No vote records are attached yet.

Versions

No version snapshots stored. Document URLs remain at the source.

Documents

10 official files

• Engrossed in Senate (text)

  Engrossed in Senate · EN · 29 June 2001

  ViewDownloadOpen at official source

• Engrossed in Senate (PDF)

  Engrossed in Senate · EN · 29 June 2001

  ViewDownloadOpen at official source

• Public Print (text)

  Public Print · EN · 29 June 2001

  ViewDownloadOpen at official source

• Public Print (PDF)

  Public Print · EN · 29 June 2001

  ViewDownloadOpen at official source

• Passed Senate amended

  summary · EN · 29 June 2001

  Open at official source

• Placed on Calendar Senate (text)

  Placed on Calendar Senate · EN · 18 June 2001

  ViewDownloadOpen at official source

• Placed on Calendar Senate (PDF)

  Placed on Calendar Senate · EN · 18 June 2001

  ViewDownloadOpen at official source

• Introduced in Senate (text)

  Introduced in Senate · EN · 14 June 2001

  ViewDownloadOpen at official source

• Introduced in Senate (PDF)

  Introduced in Senate · EN · 14 June 2001

  ViewDownloadOpen at official source

• Introduced in Senate

  summary · EN · 14 June 2001

  Open at official source

Sponsors

No sponsors or actors listed by the source.

Related records

No cross-record relationships stored yet.