Sub. H.B. 122 Summary

• Establishes standards for health care insurers operating physician rating systems, including requirements to include quality-of-care components, use accurate statistical analyses, and employ evidence-based practice guidelines.

• Requires health care insurers to appoint independent ratings examiners approved by the superintendent of insurance to ensure compliance and submit semi-annual compliance reports.

• Mandates written notification to physicians before public disclosure of their designations, with 90-day waiting period or until physician requests for methodology and data information are fulfilled (45 days maximum).

• Grants physicians the right to appeal designations through established procedures, including access to methodology and data, opportunity to submit corrected information, and completion within 45 days.

• Applies requirements equally to third-party administrators and the Medicaid program; violations constitute unfair insurance practices, and physicians may pursue legal action for damages.