PRINTER'S NO. 350
No. 321 Session of 1997
INTRODUCED BY OLASZ, ITKIN, BELARDI, MICHLOVIC, GEORGE,
MANDERINO, PETRARCA, CLARK, READSHAW, COWELL, STABACK,
LaGROTTA, DeLUCA, JAMES, MUNDY, TRELLO, ROBERTS, BOSCOLA,
BEBKO-JONES, ROHRER, RAMOS, STERN, LEDERER, THOMAS, STEELMAN,
BELFANTI AND WASHINGTON, FEBRUARY 5, 1997
REFERRED TO COMMITTEE ON HEALTH AND HUMAN SERVICES,
FEBRUARY 5, 1997
AN ACT
1 Amending the act of December 29, 1972 (P.L.1701, No.364),
2 entitled "An act providing for the establishment of nonprofit
3 corporations having the purpose of establishing, maintaining
4 and operating a health service plan; providing for
5 supervision and certain regulations by the Insurance
6 Department and the Department of Health; giving the Insurance
7 Commissioner and the Secretary of Health certain powers and
8 duties; exempting the nonprofit corporations from certain
9 taxes and providing penalties," providing for grievance
10 procedure.
11 The General Assembly of the Commonwealth of Pennsylvania
12 hereby enacts as follows:
13 Section 1. The act of December 29, 1972 (P.L.1701, No.364),
14 known as the Health Maintenance Organization Act, is amended by
15 adding a section to read:
16 Section 18.1. Grievance Procedure.--(a) Every health
17 maintenance organization shall develop a grievance procedure for
18 consumers dissatisfied with its decisions in providing health
19 care coverage.
20 (b) The Department of Health shall maintain a toll-free
1 telephone line to its Bureau of Health Care Financing for the
2 use of consumers who wish to register complaints about health
3 maintenance organizations.
4 (c) Every health maintenance organization shall distribute
5 to its direct providers and hospitals copies of a notice
6 containing its grievance procedure for distribution to its
7 consumers. The notice shall contain in large, bold-face type the
8 toll-free number provided for in subsection (b).
9 (d) Every direct provider and hospital shall post in a
10 conspicuous place a copy of the notice provided for under
11 subsection (c), and shall provide each consumer with a copy of
12 the notice.
13 Section 2. This act shall take effect in 60 days.
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