Bill Title: Relates to clarifying the grounds for an external appeal based on medical necessity; provides that where the health plan denies coverage for a health service on grounds of "medical necessity" the insured shall have the opportunity to demonstrate, through his or her health care professional, based on applicable medical and scientific evidence, the patient's record and any other pertinent information, that the proposed health service or treatment is likely to be more beneficial than any standard treatment or treatments for the patient's condition or disease or no treatment.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2010-01-06 - REFERRED TO HEALTH [S03909 Detail]

Text: Latest bill text (Introduced) [HTML]

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