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; 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, advocating on behalf of enrollees bringing claims against health carriers or referring a patient for a second opinion; requiring utilization review organizations conducting prior authorization of services to follow existing standards and 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; defining medically necessary care for health plan company requirements purposes; modifying certain health plan company continuity of care requirements, specifying certain covered services termination limits and certain notice and disclosure requirements; defining specialist for access to specialty care purposes, expanding referral procedures information disclosure requirements and requiring health plan companies to promptly evaluate the treatment needs of enrollees seeking treatment for problems relating to medical conditions including mental health and chemical dependency conditions and to pay the costs of second opinions, defining second opinion; requiring and providing for prospective enrollee access to evidences of coverage and drug formularies; requiring continued coverage of prescription drugs removed from formularies during term of the contract under certain conditions; modifying the standards for external review of adverse determinations(mk, ja)