Directs a health maintenance organization which denies a claim due to absence of medical necessity to inform the insured as to preferred alternative treatment, or provide the insured with a statement as to the past ineffectiveness of the requested procedure or treatment.
Simplifies the procedure by which injured workers obtain treatment for injuries covered by the workers' compensation law; provides that the list of pre-authorized procedures is to be used only as a list of treatment that does not require insurance carrier approval.
Simplifies the procedure by which injured workers obtain treatment for injuries covered by the workers' compensation law; provides that the list of pre-authorized procedures is to be used only as a list of treatment that does not require insurance carrier approval.
Includes chiropractic services within the definition of "comprehensive health services" for purposes of health maintenance organizations; enables a member of a health maintenance organization to request the services of a chiropractor when the member has an ailment, illness, condition or injury, the treatment for which falls within the scope of a licensed chiropractor.
Prohibits the retrospective denial of payment for substance use disorder treatment services if an insured was covered for such services at the time treatment was initiated; requires insurers to notify a treatment provider when an insured has lost coverage based on termination of the insured's employment.
Prohibits the retrospective denial of payment for substance use disorder treatment services if an insured was covered for such services at the time treatment was initiated; requires insurers to notify a treatment provider when an insured has lost coverage based on termination of the insured's employment.
Authorizes health insurers and health maintenance organizations, subject to the approval of the superintendent of financial services, to provide actuarially appropriate reductions in health insurance premiums or other benefits or enhancements for an enrollee's or insured's participation in a qualified wellness program.
Authorizes health insurers and health maintenance organizations, subject to the approval of the superintendent of financial services, to provide actuarially appropriate reductions in health insurance premiums or other benefits or enhancements for an enrollee's or insured's participation in a qualified wellness program.
Requires that non-pharmaceutical alternative treatment options including but not limited to treatment provided by a licensed acupuncturist, licensed massage therapist, licensed chiropractor, and yoga instructor be covered by the medical assistance program and by private health insurers.
Requires that insurers providing no-fault coverage reimburse other insurers for the payment of claims to providers which should have been covered by a no-fault insurer.