E Modifying certain health insurance coverage and treatment requirements; prohibiting health carriers from denying payment for services or treatments after preauthorization approval except in cases of fraud or ineligibility; prohibiting retaliation against health care providers for the disclosure of information relating to the care, services or conditions affecting enrollees to an appropriate public regulatory agency, private accreditation body or management personnel of the health plan company, for initiating, cooperating or participating in a utilization review or investigation or for providing testimony, evidence, records or other assistance to enrollees or advocating on behalf of enrollees bring claims against health carriers; requiring health plan companies to provide requesting prospective enrollees with a specimen copy of the certificate or other evidence of coverage required to be filed with the commissioners of commerce or health; requiring utilization review organizations, health plan companies or claims administrators determining inappropriate, unreasonable or medically unnecessary care to provide a copy of written procedures for prior authorization to the enrollees seeking care, requiring utilization review organizations to file annual reports with the commissioner of commerce including the number and rate of denied prior authorization requests and the number and rate of denials overturned on appeal; requiring physicians conducting reviews to be licensed in the state and to discuss review organization determinations with attending physicians and the enrollees, exempting chiropractic services from the requirement; requiring physician consultants to be board certified and licensed to practice in the same or similar specialty or area of practice involved in the request for treatment; defining medically necessary care for health plan company requirements purposes; expanding disclosure requirements relating to access to specialty care, defining specialist and requiring health plan companies to provide for referrals to appropriate specialists for certain serious conditions or diseases; "Health Care Liability Act", specifying the duty of health carriers to exercise ordinary care in making health care treatment decisions and imposing liability for certain damages, specifying certain defenses and limits, exempting workers compensation, voiding agreements or directives attempting to transfer to health care providers tort liability relating to activities, actions or omissions of health carriers, requiring enrollees to exhaust the external review process before bringing claims against health carriers (mk, ja)