D. Independent external reviews must be conducted by independent review organizations pursuant to a contract with the bureau.__The reviewers must be health care providers credentialed with respect to the health care service under review and have no conflict of interest relating to the performance of their duties under this subsection.

E. The independent review organization shall issue a written review decision based on the evidence presented to the health plan and the enrollee.__The decision of the review organization is binding on the health plan and the enrollee.

F. The superintendent may develop additional standards and adopt rules to set the fee required in paragraph B and to adopt other rules as necessary to carry out the purposes of this subsection in accordance with section 4309.

Sec. 7. 24-A MRSA §4308, sub-§2 is enacted to read:

2.__Right to sue.__An enrollee's right to sue a carrier is governed by the following provisions.

A.__A carrier has the duty to exercise ordinary care when making health care treatment decisions and is liable for damages for harm to an enrollee proximately caused by the failure of the carrier to exercise ordinary care.

B.__A carrier is liable for damages for harm to an enrollee proximately caused by the health care treatment decisions made by its employees, agents, ostensible agents or representatives who are acting on behalf of the carrier and over whom the carrier has the right to exercise influence or control when that influence or control results in the failure to exercise ordinary care.

C.__Standards of care required by paragraphs A and B do not require a carrier to provide to an enrollee treatment that is not covered by the health plan provided by the carrier.

D.__The laws of the State prohibiting a person from practicing medicine may not be asserted by a carrier as a defense in any action.

E.__In an action against a carrier, a finding that a physician or other health care provider is an employee, agent, ostensible agent or representative of the carrier may