- Introduced -

SB 984 - Under this act, it is an unfair trade practice for an insurance company to require licensed health care professionals to participate in all of the insurance company's health care or managed care plans in order to participate in another plan or policy. The insurance company shall not deny participation in one of its plans or policies simply because the licensed health care professional has decided not to participate in another plan. If an agreement is signed by an authorized representative of a group of health of health care professionals, the agreement shall apply to all members of the group.

An unfair trade practice can result in an injunction against the insurance company, a monetary penalty ($1000 per violation or $25,000 per violation if committed flagrantly) and revocation of the insurance company's license.

This act also creates a cause of action against health insurance carriers who fails to reimburse a person for health service within the statutory time period. A person whose claim is not promptly reimbursed may file a civil action to recover such payment and may also recover attorney fees and other expenses if the health carrier's failure to pay was not substantially justified.

This provision is similar to one contained in HB 1932.

STEPHEN WITTE