CODING: Words stricken are deletions; words underlined are additions.





                                                  SENATE AMENDMENT

    Bill No. CS for SB 874

    Amendment No.    

                            CHAMBER ACTION
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11  Senator Campbell moved the following amendment:

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13         Senate Amendment (with title amendment) 

14         On page 35, after line 31,

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16  insert:

17         Section 24.  Health Care Consumer Bill of Rights and

18  Responsibilities.--

19         (1)  INFORMATION DISCLOSURE.--Consumers have the right

20  to receive accurate, easily understood information, and some

21  require assistance in making informed health care decisions

22  about their health plans, professionals, and facilities. For

23  purposes of this section, the term "health plans" refers

24  broadly to indemnity insurers and managed care organizations,

25  including, but not limited to, health maintenance

26  organizations and preferred provider organizations.

27         (2)  CHOICE OF PROVIDERS AND PLANS.--Consumers have the

28  right to a choice of health care providers which is sufficient

29  to ensure access to appropriate high-quality health care.

30         (3)  ACCESS TO EMERGENCY SERVICES.--Consumers have the

31  right to access emergency health care services when and where

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 874

    Amendment No.    





 1  the need arises. Health plans should provide payment when a

 2  consumer presents to an emergency department with acute

 3  symptoms of sufficient severity--including severe pain--such

 4  that a prudent layperson could reasonably expect the absence

 5  of medical attention to result in placing that consumer's

 6  health in serious jeopardy, serious impairment to bodily

 7  functions, or serious dysfunction of any bodily organ or part.

 8         (4)  PARTICIPATION IN TREATMENT DECISIONS.--Consumers

 9  have the right and responsibility to fully participate in all

10  decisions related to their health care. Consumers who are

11  unable to fully participate in treatment decisions have the

12  right to be represented by parents, guardians, family members,

13  or other conservators.

14         (5)  RESPECT AND NONDISCRIMINATION.--

15         (a)  Consumers have the right to considerate,

16  respectful care from all members of the health care system at

17  all times and under all circumstances. An environment of

18  mutual respect is essential to maintain a quality health care

19  system.

20         (b)  Consumers must not be discriminated against in the

21  delivery of health care services consistent with the benefits

22  covered in their policy or as required by law based on race,

23  ethnicity, national origin, religion, sex, age, mental or

24  physical disability, sexual orientation, genetic information,

25  or source of payment.

26         (c)  Consumers who are eligible for coverage under the

27  terms and conditions of a health plan or program or as

28  required by law must not be discriminated against in marketing

29  and enrollment practices based on race, ethnicity, national

30  origin, religion, sex, age, mental or physical disability,

31  sexual orientation, genetic information, or source of payment.

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 874

    Amendment No.    





 1         (6)  CONFIDENTIALITY OF HEALTH INFORMATION.--Consumers

 2  have the right to communicate with health care providers in

 3  confidence and to have the confidentiality of their

 4  individually identifiable health care information protected.

 5  Consumers also have the right to review and copy their own

 6  medical records and request amendments to their records.

 7         (7)  COMPLAINTS AND APPEALS.--All consumers have the

 8  right to a fair and efficient process for resolving

 9  differences with their health plans, health care providers,

10  and the institutions that serve them, including a rigorous

11  system of internal review and an independent system of

12  external review.

13         (8)  CONSUMER RESPONSIBILITIES.--In a health care

14  system that protects consumers' rights, it is reasonable to

15  expect and encourage consumers to assume reasonable

16  responsibilities. Greater individual involvement by consumers

17  in their care increases the likelihood of achieving the best

18  outcomes and helps support a quality improvement,

19  cost-conscious environment.

20         (9)  CIVIL ENFORCEMENT.--Any person damaged by the acts

21  of a person in violation of this section may bring a civil

22  action against the person committing the violation in the

23  circuit court of the county in which the alleged violator

24  resides or has a principal place of business or in the county

25  wherein the alleged violation occurred. Upon an adverse

26  adjudication, the defendant is liable for damages, together

27  with court costs and reasonable attorney's fees incurred by

28  the plaintiff. When so awarded, court costs and attorney's

29  fees must be included in the judgment or decree rendered in

30  the case.

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 874

    Amendment No.    





 1  (Redesignate subsequent sections.)

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 4  ================ T I T L E   A M E N D M E N T ===============

 5  And the title is amended as follows:

 6         On page 5, line 4, after the semicolon;

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 8  insert:

 9         providing for a health care consumer's bill of

10         rights and responsibilities; providing for

11         enforcement;

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