SB 0144 Clarifies Health Maintenance Organizations' Responsibility For Coverage of Emergency Care
Sponsor:McKenna
LR Number:S0583.01I Fiscal Note:0583-01
Committee:Aging, Families and Mental Health
Last Action:02/11/97 - Hearing Conducted S Aging, Families & Mental Health Com. Journal page:
Title:
Effective Date:August 28, 1997
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Current Bill Summary

SB 144 - The act defines medical emergencies and emergency medical services. A medical emergency is any situation which could result in serious impairment, from the perspective and knowledge of a prudent layperson. A health maintenance organization (HMO) must allow 24 hour emergency care without preauthorization. Necessary emergency care must be approved within 30 minutes or it is deemed to be approved. When there is a disagreement between an attending physician and the HMO as to care, and the patient remains unstable, the HMO assumes any financial responsibility.

If a primary care physician or the HMO has authorized an evaluation or treatment, the HMO cannot subsequently deny the evaluation or treatment.
CHERYL GRAZIER