Section C talks about how if they want to delay or deny any medication/procedure that was recommended by a physician that in needs to be by another physician. There’s already a loophole in place for this section which is that insurance companies hire loads of physicians to look at case files and determine if it should be denied or not. There is obviously a huge conflict of interest there, but that’s how that works.
However, section D talks about how if they delay or deny anything, the insurance company has the burden of proof and would have to pay for any damages or legal fees in doing so. That part is HUGE! Accountability in the court for this bullshit!
Source: Not a lawyer, but work for one of the largest health insurers in the US.
section E makes decisions made by a non-physician also a felony, should be expanded to make influencing a physician to lie also a felony, protecting physicians employed by insurance company from reprisal.
Section C talks about how if they want to delay or deny any medication/procedure that was recommended by a physician that in needs to be by another physician. There’s already a loophole in place for this section which is that insurance companies hire loads of physicians to look at case files and determine if it should be denied or not. There is obviously a huge conflict of interest there, but that’s how that works.
However, section D talks about how if they delay or deny anything, the insurance company has the burden of proof and would have to pay for any damages or legal fees in doing so. That part is HUGE! Accountability in the court for this bullshit!
Source: Not a lawyer, but work for one of the largest health insurers in the US.
section E makes decisions made by a non-physician also a felony, should be expanded to make influencing a physician to lie also a felony, protecting physicians employed by insurance company from reprisal.