A bill to amend title I of the Employee Retirement Income Security Act of 1974 to provide to participants and beneficiaries of group health plans access to unrestricted medical advice

4 Pages·1999·0.18 MB·English

by  United States. Congress. House

.
i
106t1hstCSOeNssGiRoEnSS H. R. 2043
Toamendtitle Iofthe EmployeeRetirementIncomeSecurityActof1974
toprovidetoparticipantsandbeneficiariesofgrouphealthplansaccess
tounrestrictedmedicaladvice.
IN THE HOUSE OF REPRESENTATIVES
June8,1999
Mrs.Kellyintroducedthefollowingbill;whichwasreferredtothe
CommitteeonEducationandtheWorkforce
A
BILL
To amend title I ofthe Employee Retirement Income Secu-
rity Act of 1974 to provide to participants and bene-
ficiaries of group health plans access to unrestricted
medicaladvice.
1 BeitenactedbytheSenateandHouseofRepresenta-
2 tivesoftheUnitedStatesofAmericainCongressassembled,
3 SECTION1.SHORTTITLE.
4 ThisActmaybecitedasthe"PatientRighttoUnre-
5 strictedMedicalAdviceActof1999"
2
1 SEC.2.PATIENTACCESSTOUNRESTRICTEDMEDICALAD-
2 VICE.
—
3 (a) In General. Subpart B ofpart 7 of subtitle
4 B oftitleI oftheEmployee RetirementIncome Security
5 Actof1974isamendedbyaddingattheendthefollowing
6 newsection:
7 "SEC. 714. PATIENTACCESSTO UNRESTRICTED MEDICAL
8 ADVICE.
—
9 "(a) In General. In the case ofany health care
10 professional actingwithinthe lawful scope ofpractice in
11 the course ofcarrying out a contractual employment ar-
12 rangement or other direct contractual arrangement be-
13 tween such professional and a group health plan or a
14 healthinsuranceissuerofferinghealthinsurancecoverage
15 incomiectionwithagrouphealthplan,theplanorissuer
16 withwhich such contractual employment arrangement or
17 otherdirectcontractualarrangementismaintainedbythe
18 professional may not impose on such professional under
19 such arrangement anyprohibition or restrictionwith re-
20 spect to advice, provided to a participant or beneficiary
21 undertheplanwho is apatient, aboutthe health status
22 ofthe participant or beneficiary or the medical care or
23 treatment for the condition or disease ofthe participant
24 orbeneficiary,regardlessofwhetherbenefitsforsuchcare
25 ortreatmentareprovidedundertheplanorhealthinsur-
26 ancecoverageofferedinconnectionwiththeplan.
•HR2043IH
—
1 "(b) Health CareProfessionalDefined. For
2 purposesofthissection,theterm'healthcareprofessional'
3 means a physician (as defined in section 186l(r) ofthe
4 Social SecurityAct) or other health care professional if
5 coverage fortheprofessional's services isprovidedunder
6 thegrouphealthplanfortheservicesoftheprofessional.
7 Suchtermincludesapodiatrist,optometrist,chiropractor,
8 psychologist,dentist,physicianassistant,physicaloroccu-
9 pationaltherapistandtherapyassistant, speech-language
10 pathologist, audiologist, registered or licensed practical
11 nurse (including nurse practitioner, clinical nurse spe-
12 cialist, certifiedregisterednurseanesthetist,andcertified
13 nurse-midwife),licensedcertifiedsocialworker,registered
14 respiratory therapist, and certified respiratory therapy
15 technician.".
—
16 (b) Conforming Amendment. The table of con-
17 tents in section 1 ofsuchAct is amended by adding at
18 the end ofthe items relating to subpart B ofpart 7 of
19 subtitle B oftitle I ofsuchAct the followingnewitem:
"Sec.714.Patientaccesstounrestrictedmedicaladvice.".
20 SEC.3.EFFECTIVEDATEANDRELATEDRULES.
—
21 (a) In GENERAL. The amendments made by this
22 Act shall applywith respect to plan years beginning on
23 or after January 1 ofthe second calendaryearfollowing
24 thedateoftheenactmentofthisAct,exceptthattheSec-
25 retary of Labor may issue regulations before such date
•Hit2043III
CI1SLIBRARY
4 3 DDIillIIII11II
1 under such amendments. The Secretary shall first issue
2 regulations necessaryto carryoutthe amendments made
3 bythisActbeforetheeffectivedatethereof.
—
4 (b) Limitation on Enforcement Actions. No
5 enforcementactionshallbetaken,pursuanttotheamend-
6 ments made bythisAct, against a group health plan or
7 healthinsuranceissuerwithrespecttoaviolationofare-
8 quirement imposed by such amendments before the date
9 ofissuance ofregulations issued in connectionwith such
10 requirement, ifthe plan or issuer has sought to comply
11 ingoodfaithwithsuchrequirement.
O
•HR2043IH