Establishes the Healthcare Claims Consumer Assistance Program (H-CAP) to assist consumers with health insurance claims and penalizes health plans or.
The Fair Claims Accountability Act establishes the Healthcare Claims Consumer Assistance Program (H-CAP) within the Department of Consumer Affairs. H-CAP aims to assist consumers with filing complaints, appeals, and grievances, and to educate consumers on their health insurance rights. The act prohibits health plans and insurers from wrongfully denying or insufficiently covering valid consumer insurance claims. It mandates annual reporting by the Department of Consumer Affairs on denied claims data, investigations, and outcomes.
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- Core Provisions
- Implementation
- Impact
- Legal Framework
- Critical Issues
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