PlainBillCongress, translated.Legislation. Context. Public interest.Forwarded by Subcommittee to Full Committee (Amended) by the Yeas and Nays: 11 - 7.
Congressional Research Service
Version 00 · Introduced in House · Jun 9, 1999
Group Health Plan Review Standards Act of 1999 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to require group health plans to provide written notice of adverse coverage decisions to participants or beneficiaries and care providers.Requires group health plans to meet specified time limits for: (1) making decisions on requests for benefit payments, advance determination of coverage, and medical necessity determinations; and (2) making coverage decisions relating to accelerated need medical care, and for completing internal reviews of initial denials of such coverage.Requires internal reviews by medical professionals of initial coverage decisions involving: (1) medical appropriateness or necessity; (2) investigational items; or (3) experimental treatment or technology.Allows participants or beneficiaries, under certain conditions, to request external review by an independent medical expert of an adverse coverage decision and reconsideration of the initial review decision.Sets forth: (1) permitted alternatives to required internal reviews and required external reviews; (2) review requirements; and (3) a fiduciary standards compliance requirement.
People & committees
Rep. Boehner, John A. [R-OH-8] · R–OH
Legislative record
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Forwarded by Subcommittee to Full Committee (Amended) by the Yeas and Nays: 11 - 7.
Subcommittee Consideration and Mark-up Session Held.
Referred to the Subcommittee on Employer-Employee Relations.
Referred to the House Committee on Education and the Workforce.
Introduced in House
Introduced in House
Primary sources
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Source last updated: Mar 23, 2026. Consult Congress.gov for the current record.
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