§ 31A-2-216. Office of Consumer Health Assistance.

(1) The commissioner shall establish:

(a) an Office of Consumer Health Assistance before July 1, 1999; and

(b) a committee to advise the commissioner on consumer assistance rendered under this section.

(2) The office shall:

(a) be a resource for health care consumers concerning health care coverage or the need for such coverage;

(b) help health care consumers understand:

(i) contractual rights and responsibilities;

(ii) statutory protections; and

(iii) available remedies;

(c) educate health care consumers:

(i) by producing or collecting and disseminating educational materials to consumers, health insurers, and health benefit plans; and

(ii) through outreach and other educational activities;

(d) for health care consumers that have difficulty in accessing their health insurance policies because of language, disability, age, or ethnicity, provide services, directly or through referral, such as:

(i) information and referral; and

(ii) adverse benefit determination process initiation;

(e) analyze and monitor federal and state consumer health-related statutes, rules, and regulations; and

(f) summarize information gathered under this section and make the summaries available to the public, government agencies, and the Legislature.

(3) The office may:

(a) obtain data from health care consumers as necessary to further the office's duties under this section;

(b) investigate complaints and attempt to resolve complaints at the lowest possible level; and

(c) assist, but not testify or represent, a consumer in an adverse benefit determination, arbitration, judicial, or related proceeding, unless the proceeding is in connection with an enforcement action brought under Section 31A-2-308.

(4) The commissioner may adopt rules necessary to implement the requirements of this section.

Amended by Chapter 308, 2002 General Session