This bill proposes the establishment of a health care claims consumer assistance program within the Department of Insurance and Financial Institutions, aimed at supporting consumers enrolled in or seeking to enroll in health plans. The program will assist consumers with filing complaints and appeals, settling disputes with health insurers, and educating them about their rights regarding health insurance coverage. Additionally, the bill introduces provisions for civil penalties against health insurers that repeatedly violate health plans, including automatic liability for double the amount of wrongfully denied claims, and allows for the assessment of additional damages based on the severity of violations.

Furthermore, the bill mandates the Department to maintain records of wrongful claims denials, require health insurers to disclose data on denied claims, and review violations for potential penalties. It also establishes annual reporting requirements for the Department to compile and publicly post data on denied claims and the outcomes of investigations into health insurers. The bill includes appropriations from the state general fund to support the program and exempts these funds from lapsing provisions.

Statutes affected:
Introduced Version: 20-128