Relates to utilization review program standards; requires use of evidence-based and peer reviewed clinical review criteria; relates to prescription drug formulary changes and pre-authorization for certain health care services.
Directs the department of financial services to conduct a study examining the increasing costs of insurance premiums, the lack of availability of insurance coverage for losses from flooding, and the possibility of supporting a private flood insurance market in the state.
Authorizes localities to provide for an additional real property tax exemption for senior citizens who meet the income eligibility limits and other criteria to the extent of sixty-five percent of the assessed valuation of such real property.
Extends period during which health maintenance organization enrollees may continue to receive services from a health care provider who disaffiliates from 60 or 90 days to 1 year, or in case of terminal illness, until the time of such insured's death; bars incentives which induce a provider to provide health care to an enrollee in a manner inconsistent with law.
Provides for increased podiatry care and benefits under individual and group accident and health insurance policies and contracts within non-profit medical and dental indemnity, or health and hospital service corporations.