- House Committee Substitute -

HCS/SS/SCS/SB 754 - This act requires health services corporations and health maintenance organizations to provide, within their network, coverage of second opinions of diagnoses for serious debilitating conditions and illnesses. If another primary physician or specialist capable of providing a second opinion is not available within the HMO's network, the HMO is required to arrange a referral at no greater cost to the patient than if the benefit were obtained from a participating physician.

The act also sets certain requirements for all health insurers regarding claims for reimbursement. Within 45 days of a claim for reimbursement, all insurers must either pay the claim, or report on the status of the claim. Failure to meet these provisions forces an insurer to pay interest on the amount of the claim that remains unpaid after 45 days at a monthly rate of 1.5%.

JOHN MESSMER