HB2435 Summary

• Amends the Managed Care Reform and Patient Rights Act to establish liability standards for health insurance carriers, health maintenance organizations, and managed care entities when making health care treatment decisions.

• Health care entities must exercise ordinary care when making treatment decisions and are liable for damages proximately caused by failure to exercise that care, including harm caused by decisions made by their employees, agents, or representatives.

• Prohibits health care entities from removing or refusing to renew physicians or health care providers for advocating on behalf of enrollees for appropriate and medically necessary care.

• Prohibits health care entities from entering into contracts with providers that include indemnification or hold harmless clauses protecting the entity, and voids any existing such clauses in current contracts.

• Requires disputes to be submitted to arbitration under the Uniform Arbitration Act with awards due within 30 days; exempts workers' compensation insurance, licensed insurance agents, and utilization review determination disputes.