HARRY HUGHES, Governor                                       1237

ENTITIES, INCLUDING THE DIVISION, THE ATTORNEY GENERAL OR OTHER
GOVERNMENTAL AGENCIES, INSURERS, OR PROVIDERS.

(2) WHENEVER ANY BILLING OR COVERAGE QUESTION
CONCERNS THE ADEQUACY OR PROPRIETY OF ANY SERVICES OR TREATMENT,
THE UNIT SHALL REFER THE MATTER TO AN APPROPRIATE PROFESSIONAL,
LICENSING, OR DISCIPLINARY BODY, IF AS APPLICABLE. THE UNIT MAY

REPRESENT THE INTERESTS OF A HEALTH CONSUMER BEFORE ANY SUCH

BODY. THE UNIT MAY MONITOR THE PROGRESS OF THE CONCERNS RAISED
BY HEALTH CONSUMERS THROUGH SUCH REFERRALS.

(3) WHENEVER ANY BILLING OR COVERAGE QUESTION
CONCERNS A MATTER WITHIN THE JURISDICTION OF THE INSURANCE
COMMISSIONER, THE UNIT SHALL REFER THE MATTER TO THE
COMMISSIONER, AND MAY REPRESENT THE INTERESTS OF A HEALTH CARE
CONSUMER BEFORE THE COMMISSIONER. THE UNIT MAY MONITOR THE
PROGRESS OF THE CONCERNS RAISED BY HEALTH CONSUMERS THROUGH SUCH
REFERRALS.

(4) THE UNIT SHALL WORK WITH THE DEPARTMENT OF HEALTH
AND MENTAL HYGIENE TO ASSIST WITH RESOLVING ANY BILLING OR
COVERAGE QUESTIONS AS NECESSARY.

(C) THE UNIT MAY;

(1) RECOMMEND TO THE ATTORNEY GENERAL, THE GOVERNOR,
THE GENERAL ASSEMBLY, OR OTHER APPROPRIATE GOVERNMENTAL AGENCIES
ANY MEASURES THAT WILL PROMOTE THE INTERESTS OF HEALTH CONSUMERS
IN THE HEALTH MARKETPLACE; AND

(2) APPEAR AS AN INTERESTED PARTY IN ANY AGENCY
MATTER THAT IS OTHERWISE OPEN TO THE PUBLIC AND AFFECTS HEALTH
CARE CONSUMERS.

(D) THE UNIT SHALL WORK WITH THE TECHNICAL AND PROFESSIONAL
STAFF OF THE DEPARTMENT OF HEALTH AND MENTAL HYGIENE TO ASSIST
WITH RESOLVING ANY BILLING OR COVERAGE QUESTIONS AS NECESSARY.

(2) PRESENT FOR CONSIDERATION RELEVANT INFORMATION ON
THE EFFECTS ON HEALTH CARE CONSUMERS GENERALLY IN ANY AGENCY
PROCEEDING WHICH IS OTHERWISE OPEN TO THE PUBLIC.

(D) NOTHING IN THIS SECTION SHALL MEAN THAT THE UNIT MAY
HAVE AUTHORITY TO BRING ANY CIVIL ACTION SEEKING REVIEW OF A
STATE AGENCY DETERMINATION.

13-4A-03.

TO THE EXTENT POSSIBLE, THE ATTORNEY GENERAL'S OFFICE SHALL
INCLUDE IN ITS ANNUAL BUDGET FUNDS FOR THE ADMINISTRATION AND
OPERATION OF THE UNIT.