Relating to health, providing for patient protections; clarifying and+ modifying the provision prohibiting accident and health insurers from +retroactively denying coverage for preauthorized expenses, requiring communication +to the enrollee of service or treatment coverage at the same time as the +determination of medical necessity; expanding the provisions prohibiting health +plan company retaliatory action against health care providers or enrollees or +patients, authorizing enrollees or patients to participate in utilization +reviews and to seek a second opinion; requiring utilization review organizations, +health plan companies or claims administrators determining care as inappropriate, unreasonable or medically unnecessary to provide copies of the +procedures used to enrollees seeking the care, requiring the physician reviewer to be+ available to discuss the determination with the attending physician and +enrollee; strengthening a certain requirement of health plan companies to cover+ mental health services; defining specialist for specialty care access +purposes and imposing certain mandatory referral requirements on health plan +companies; clarifying certain referral procedures disclosure requirements; +requiring health plan companies to promptly evaluate the treatment needs of +enrollees seeking treatment for medical conditions; requiring and providing for+ enrollee or prospective enrollee access to evidence of coverage and drug +formularies; prohibiting health plans providing coverage for prescription drugs +from limiting or excluding coverage of a drug removed from the formulary +during the term of the enrollee contract under certain conditions; modifying +certain standards for external review of adverse determinations (ra)