SB 6486 - DIGEST

     Declares an intent to ensure that:  (1) Enrollees have full and timely access to clinically and culturally appropriate health care personnel and facilities;

     (2) enrollees have adequate choice among health care professionals who are accessible and qualified;

     (3) enrollees have access to comprehensive pharmaceutical services;

     (4) enrollees have access to information regarding limits on coverage of experimental treatments;

     (5) enrollees are provided with a high quality of preventative and other health care within a managed care plan, designed to maintain and improve an enrollee's health status;

     (6) medical decisions are made by the appropriate medical personnel;

     (7) health care professionals within a plan are practitioners in good standing;

     (8) managed care plan data are available as appropriate;

     (9) there is full public access to information regarding health care service delivery within plans;

     (10) there is a fair vehicle for resolving enrollee complaints in a managed care system;

     (11) there is timely resolution of enrollee grievances and appeals;

     (12) managed care plan advertisements are true, accurate, and not misleading; and

     (13) enrollees have access to the civil justice system when injured by decisions made in a managed care system.