Newsletters

State Legislative Update

February 7 - February 11, 2000

		Government Affairs Newsletters Washington Updates Hey, Wait A Minute State Legislative Updates Through the Grapevine

Antitrust

In Tennessee, Representative Curtis introduced H.B. 2396, known as the Health Care Provider Joint Negotiations Act on February 3, 2000. This measure is identical to S.B. 2672, which was introduced on January 20, 2000 by Senator Cohen.

Children’s Health Insurance Program (CHIP)

Action was taken on CHIP bills in nine states—Hawaii, Illinois, Indiana, Missouri, New Mexico, Tennessee, and Utah.

In Hawaii, Representative Arakaki introduced H.B. 1920 on January 21, 2000. The bill was referred to the House Committee on Health, and makes emergency appropriation for CHIP. Representative Arakaki also introduced H.B.2912 on January 27, 2000. The bill was referred to the House Committee on Human Services and Housing. The bill makes appropriation for CHIP.

In Illinois two bills, H.B. 4212 and H.B. 4213, were introduced by Representative Daniels on February 3, 2000. The bills were referred to the House Committee on Rules on the same day. The bills amend CHIP Act and make a technical change in a section concerning the legislative intent of the Act.

In Indiana, Senator Miller introduced S.B. 504 on January 10, 2000. An amended version of this bill passed the Committee on Health and Provider Services and was passed by the Senate. The bill was sent to the House Committee on Ways and Means. S.B. 504 defines emergency for purposes of CHIP and prohibits cost sharing under CHIP for emergency services provided within a hospital emergency department. The measure requires the state Office of Medicaid Policy and Planning and the state department that administers CHIP to request repayment of any overpayment made to a provider under the Medicaid program or CHIP.

In Missouri, Representative Naeger introduced H.B. 1719 on January 25, 2000. On February 3, 2000 the bill was referred to the House Committee on Social Services, Medicaid and the Elderly. This bill requires all offices of the State Division of Family Services and all other locations where CHIP applications are received to post a warning sign that the program is scheduled to expire on July 1, 2002.

In New Mexico, Representative Begaye’s bill H.B. 299, was introduced on January 28, 2000. The bill was referred to the House Committee on Consumer and Public Affairs, then referred to the House Committee on Appropriations and Finance where it was passed as amended. The bill relates to the CHIP Phase Two Plan.

In Tennessee, two bills were introduced. Representative McDaniel introduced H.B. 3230 on February 2, 2000. The bill enacts Tennessee Managed Care Medicaid Reform, CHIP and Tennpool Act of 2000.

Senator Fowler introduced S.B. 3168 on February 2, 2000. The bill was referred to the Senate Committee on Commerce, Labor and Agriculture. The bill enacts Tennessee Managed Care Medicaid Reform, CHIP and Tennpool Act of 2000.

In Utah Representative Dayton introduced H.B. 159 and H.B. 271 on January 26, 2000 and January 27, 2000 respectively. Both measures were referred to the House Committee on Rules. H.B. 159 requires a hospital to include on an itemized billing statement any amount charged to the patient in order to pay for the CHIP hospital provider assessment. H.B. 271 repeals the hospital provider assessment and appropriates funds from the state's share of the tobacco settlement account for CHIP. The bill was sent to the House Standing Committee and then to the House Committee on Health and Human Services on February 1, 2000.

Senator Nielson introduced S.B. 267 on January 29, 2000. The bill was sent to the Senate Committee on Rules on February 2, 2000 and was printed. The bill repeals the hospital providers’ assessment and appropriates annually from the tobacco settlement account for CHIP.

Confidentiality

S.B. 371 was introduced in Maryland by Senator Hollinger on February 3, 2000, and referred to the Senate Committee on Economic and Environmental Affairs. This bill would establish that any person may be held liable for punitive damages if they knowingly obtain another individual’s medical records under a false pretense through deception with an intent to sell, transfer or use the individual’s identifiable medical information. A state advisory council on medical privacy and confidentiality would also be established to conduct hearings, monitor federal laws, and make recommendations to the general assembly regarding privacy and confidentiality of medical records.

On February 7, 2000 in South Dakota, H.B. 1175 sponsored byRepresentative Hunt passed the House and was submitted to the Senate. This act would authorize the state Director of Insurance to protect the privacy of any identifiable medical information. The Director would be given the authority to impose rules to protect the confidentiality of an individual’s medical records.

Representative Hunt also sponsored H.B. 1176 in South Dakota. On February 8, 2000 the House Committee on State Affairs amended this measure. The Department of Health would be authorized to develop rules to protect the privacy of personally identifiable medical information or records.

Genetic Testing

Legislation prohibiting insurance carriers from requesting genetic information from enrollees, or from requiring enrollee disclosure of genetic information, was introduced on February 2, 2000 in Rhode Island by Representative McNamara. H.B. 7213 was referred to the House Committee on Corporations on the same date.

Health Insurance Tax Incentive

Representative Gibson in Alabama sponsored H.B. 81, a measure to amend an existing law regarding income tax deductions to allow self-employed individuals to deduct the cost of medical insurance for his/her self, the individual’s spouse and dependents. This measure was referred to the House Committee on Ways and Means Education Fund on February 1, 2000.

In Colorado, H.B. 1295 sponsored by Representative Lawrence was submitted to the House Committee on Appropriations on February 7, 2000. This bill would amend the state’s existing law concerning health insurance tax incentives by replacing the term “tax deduction” with “tax credit.” A tax credit would now be available to employers who contribute to MSAs for employees. The credit would equal 25 percent of the total amount the employer contributes, but the credit may not exceed $50,000 per year. Any credit that exceeds the employer’s tax liability may be carried over and used during the following five years.

Two bills have been introduced in Missouri regarding health credit. H.B. 1392, introduced on January 11, 2000 by Representative Kreider, has been referred to the House Committee on Missouri Tobacco Settlement. Small employers who join a private health insurance purchasing cooperative and have not paid for employees’ health insurance in the past, but now offer health insurance to eligible employees shall be allowed a tax credit. The credit shall equal $50 each month per employee for the first two years. A $35 per month per employee tax credit is granted for the third and fourth years and for subsequent years a $25 per month per employee tax credit is granted. For small employers that currently purchase health insurance for the employees, a tax credit equal to $25 per month per employee shall be granted. The credit is contingent on the state receiving monies for a settlement from the tobacco product manufacturers.

The second bill in Missouri is H.B. 1829 introduced on January 31, 2000 by Representative Levin. This measure amends an existing law relating to income taxation. This measure would allow individuals to subtract 100 percent of the cost of health insurance premiums and any out-of-pocket medical costs for the purposes of determining state income tax liability

In Vermont Representative Nitka sponsored H.B. 819, which was referred to the House Committee on Health and Welfare. This measure specifies that a taxpayer shall be eligible for a nonrefundable income tax credit equal to four percent of any health insurance costs to cover the taxpayer, the taxpayer’s spouse or the taxpayer’s dependents.

Also in Vermont, Representative Nitka sponsored H.B. 821, which would provide an income tax credit to small business employers that employ between two and 25 full-time employees. The credit would equal four percent of the total cost of premiums for health insurance for all employees. To qualify for the credit, the employer must pay 80 percent of the total premium costs. This bill was sent to the House Committee on Health and Welfare on February 2, 2000.

Wisconsin A.B. 456 was sponsored by Assembly Member Hahn and referred to the Assembly Committee on Rules on February 2, 2000. This measure would change the existing individual income tax deduction from 50 percent to 100 percent of the costs paid by an individual for health insurance coverage for the individual, his or her spouse and/or the individual’s dependents. To qualify, an individual must be employed and pay for his/her own health insurance.

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

In Hawaii three bills were introduced. Action was taken on HIPAA measures in Hawaii. Rep. Hiraki and Sen. Taniguchi introduced H.B. 2707 and S.B. 2292 on January 27, 2000 and January 21, 2000 respectively. Both of these measures require group and individual health insurance to comply with the federal HIPAA requirements. Representative Hiraki also introduced H.B. 2797 on January 27, 2000. The bill was referred to the House Committee on Consumer Protection and Commerce on January 31, 2000. The bill requires group and individual health insurance to comply with the federal HIPAA requirements.

Health Plan Liability

Health plan liability legislation was addressed in two states. In Illinois, H.B. 4304, sponsored by Representative Scully, was submitted to the House Committee on Rules on February 3, 2000. This measure would amend the Managed Care Reform and Patient Protection Acts. It specifies that a health insurance carrier, HMO, or other managed care entity must exercise ordinary care when making healthcare treatment decisions, or it can be found liable for harm caused to the insured or enrollee.

In Tennessee, Representative Bowers sponsored H.B. 2856, and on February 3, 2000 it was referred to the House Committee on Judiciary. The Patient’s Bill of Rights for Managed Care Act would be amended to include that HMOs or health plan carriers that provide a managed care plan must exercise ordinary care when making healthcare treatment decisions. The HMO or managed care carrier would be liable for damages if it fails to exercise ordinary care and the insured or enrollee is harmed.

Health Purchasing Cooperatives

In Massachusetts, S.B. 701, sponsored by Senator Tarr, has been set aside for study. This bill would create the Massachusetts Small Group Purchasing Program and Health Insurance Purchasing Cooperatives, and it would also provide marketing requirements for information on participating health partnerships.

Long-Term Care

Eleven states—Alabama, Hawaii, Indiana, Kansas, Minnesota, Missouri, Nebraska, New Jersey, Oklahoma, Rhode Island and West Virginia—addressed long-term care bills during the reporting period. In Alabama, two measures were introduced. Representative Newton sponsored H.B. 170, which was assigned to the House Committee on health on February 1, 2000. This measure, known as the Long-Term Care Insurance Policy Minimum Standards Act” would grant the state Insurance Commissioner regulatory authority over the sale and issuance of long-term care policies. The bill would also establish certain minimum standards concerning the sale of long-term care insurance, according to the model standards developed by the National Association of Insurance Commissioners. Companion legislation, known as S.B. 187, was introduced by Senator Butler on February 1, 2000, and assigned to the Senate Committee on Banking and Insurance the next day.

In Hawaii, a measure introduced by Representative Arakaki on January 27, 2000, was assigned to the House Committees on Human Services and Housing and Health on January 31, 2000. H.B. 2916 appropriates funds for a state program to subsidize a portion of long-term care premium expenses for individuals over age 65 on a sliding scale basis.

In Indiana, legislation sponsored by Senator Miller on January 10, 2000 passed the Senate on February 7, 2000. S.B. 319 would require the state to establish a voluntary program to allow public employees to purchase group long-term care insurance and establish that the state would pay 20 percent of premium costs.

Representative Findley, of Kansas, introduced H.B. 2835 on February 2, 3000. This bill would allow individuals to deduct up to $2000 in qualified long-term care insurance premiums from their state income tax liability each year. This bill was assigned to the House Committee on taxation on February 3, 2000.

In Minnesota, Representative Dehler sponsored H.F. 3044 on February 7, 2000. This bill, which was assigned to the House Committee on Taxes, would eliminate an inflation-protection requirement in the state’s existing long-term care tax credit law.

Missouri H.B. 1737 was introduced on January 25, 2000 by Representative Monaco. This bill would require long-term care insurance carriers to identify to consumers whether or not plans are tax qualified. This bill also requires the state Department of Insurance to publish a consumer’s guide to long-term care insurance. On February 3, 2000, H.B. 1737 was assigned to the House Committee on Insurance.

In Nebraska, long-term care legislation introduced by Representative Jensen in January of 2000 passed the Committee on Banking, Commerce and Insurance on February 3, 2000 and was placed on General file. This measure would, among other things, define qualified long-term care insurance policies, and require carriers to disclose to purchasers whether or not a policy is considered to be tax-qualified.

Senator Singer, of New Jersey, prefiled S.B. 945 on February 8, 2000. The full text of this bill is not yet available, but the intent is to create business and income tax credits to encourage the purchase of private long-term care insurance.

S.B. 1425, introduced on February 7, 2000 in Oklahoma by Senator Henry, would declare that for tax years beginning after December 31, 2000, monies paid by an individual for a long-term care insurance policy to insure either the taxpayer or a spouse are exempt from taxable income.

In Rhode Island, Representative Ginaitt introduced legislation on February 3, 2000 that was assigned to the House Committee on Finance. This bill would create a personal income tax credit for individuals that buy private long-term care insurance.

Two long-term care bills were introduced in West Virginia this reporting period. Both H.B. 4354, sponsored by Delegate Cann, and S.B. 404, sponsored by Senator Helmick, would allow individuals to deduct payments made during the taxable year for long-term care insurance for themselves, a spouse, parent or dependent, from their federal adjusted gross income for the purposes of determining state income tax liability. H.B. 4354 was assigned to the House Committee on Finance on February 2, 2000, and S.B. 404 was referred to the Senate Committee on banking and Insurance on February 4, 2000.

Managed Care Reform/Patient Protection

Three bills were introduced in Maryland. Representative Goldwater introduced H.B. 367, which was submitted to the House Committee on Environmental Matters on February 2, 2000. This measure expands a patient’s choice of health care providers within a Health Maintenance Organization (HMO). A nurse practitioner would have the same responsibilities and privileges as a physician within the health plan.

Senator Dorman introduced S.B. 325, also in Maryland, on February 2, 2000. This is the same bill as H.B. 367.

In Maryland, Senator Exum introduced S.B. 567 on February 4, 2000 and it was referred to the Senate Committee on Finance. This measure would classify an obstetrician/gynecologist as a woman’s primary care provider under an HMO health plan. A woman may also choose to select an in-network certified mid-wife as her obstetric primary care provider.

Two similar bills were introduced in Tennessee on February 2, 2000. Representative Kisber introduced H.B. 3072 and Senator Rochelle introduced S.B. 3039. These bills would provide that in the case of an enrollee who has been determined by his/her physician to have a life-threatening illness, the internal appeals procedure does not need to be completed before initiating an independent review process of a health plan’s treatment decision.

In Virginia, Representative Cranwell introduced H.B. 915 on January 24, 2000. This measure would amend current law regarding managed care health insurance plans. This bill allows an individual that is covered under a managed care plan to select the health care provider of their choice, whether the provider is in or out of network. An out-of network provider may agree to accept payment for services that are imposed by the individual’s plan.

Representative Fleischauer in West Virginia introduced H.B. 4363, which was submitted to the House Committee on Government Organization on February 2, 2000. This measure amends an act relating to patient’s bill of rights. It specifies that an HMO must supply to all plan subscribers a consumer guide that includes enrollee’s rights and responsibilities, plan benefits, benefit limitations, health plan premiums, and co-payment requirements.

Mandates

State lawmakers took action on mandate bills in 11 states–Arizona, Florida, Illinois, Indiana, Kansas, Maryland, Mississippi, New York, Rhode Island, South Dakota and Virginia. In Arizona, mandate legislation introduced by Senator Day was amended by the Senate Committee of the Whole on February 3, 2000. S.B. 1059 would require certain health insurance carriers to cover expenses incurred by enrollees participating in certain clinical trials for the treatment of cancer.

In Florida, Senator Lee introduced S.B. 1178 on February 3, 2000. This bill would prohibit certain health insurance carriers from denying qualified enrollees from participating in approved clinical trials and require them to provide such enrollees with coverage and reimbursement of costs. S.B. 1178 was assigned to the Senate Interim Committees on Banking and Insurance, Health Aging and Long-Term Care, and Fiscal Policy.

Representative Crotty, of Illinois, introduced H.B. 3262 on January 19, 2000. This bill would amend the state’s Health Maintenance Organization Act by requiring parity in the coverage of diagnostic or surgical procedures involving facial bones or joints if the policy provides similar coverage for procedures involving other bones and joints of the skeleton. This measure was referred to the House Committee on Rules on January 26, 2000, and assigned to the House Committee on Health Care Availability and Access on February 2, 2000.

Also in Illinois, Senator Ronen sponsored S.B. 1720, which would amend existing law to require certain health insurers and managed care entities to include in their policies coverage of all generally medically accepted cancer-screening tests.

In Indiana, legislation introduced by Representative Ruppel concerning mandating insurance coverage for colorectal cancer screening examinations and laboratory tests was amended on the House floor on February 1, 2000 and ordered engrossed.

The Kansas Senate’s Committee on Financial Institutions and Insurance introduced S.B. 523 on January 31, 2000. This bill was assigned to that committee on February 1, 2000, and it would prohibit certain health insurers from limiting reimbursement for maintenance drugs to a 90-day supply.

On February 3, 2000 in Maryland, Representative Hixson introduced S.B. 268, which was referred to the House Committee on Economic Matters. This bill would require certain health insurers to provide coverage for children’s hearing aids.

In Mississippi, Representative McCoy introduced legislation that would require certain insurance policies to provide benefits for infertility treatment services. This measure was assigned to the House Committee on Insurance on February 1, 2000.

Three mandate bills were addressed in New York during the reporting period. Two bills concerning infertility passed their respective chambers. A.B. 7303, sponsored by Assembly Member Silver, passed the Assembly on February 2, 2000 and was assigned to the Senate Committee on Insurance. This bill would require certain health insurers to provide coverage for the diagnosis and treatment of infertility. S.B. 3131, sponsored by Senator LaValle, passed the Senate on February 8, 2000, and was referred to the Assembly Insurance Committee. This measure would require certain insurers to provide coverage for the care and treatment of conditions that cause infertility.

Also in New York, Assembly Member Coleman introduced A.B. 9448 on February 3, 2000. This bill would require insurance polices that include coverage of prescription drugs to also include coverage of any single source drug prescribed for an enrollee for as long as the drug is medically necessary for the enrollee’s therapy. A.B. 9448 was assigned to the Assembly Committee on Insurance on February 3, 2000.

Senator McBurney, of Rhode Island, introduced legislation to require certain health insurance carriers to provide enrollees coverage of all drugs prescribed for an enrollee, regardless if the drug is not part of the carrier’s formulary.

In South Dakota, H.B. 1133 would require certain health insurers to provide coverage for the off-label use of prescription drugs prescribed to treat life-threatening illnesses. This legislation, which was sponsored by Representative Roe, passed the House Committee on Commerce with an amendment on February 1, 2000, and was adopted on the House floor on February 2, 2000.

Delegate Armstrong of Virginia, introduced H.B. 1376 on January 24, 2000. This measure concerns supplies for the treatment of diabetes, and it would prohibit insurance carriers from categorizing diabetic supplies as durable medical equipment, thereby ensuring that such supplies would not be subject to the durable equipment dollar limits. H.B. 1376 passed the House on February 8, 2000.

Mental Health and/or Substance Abuse Treatment Parity

Legislation addressing insurance parity for mental health and/or substance abuse treatment services was considered by the following five states–Arizona, Kansas, Massachusetts, New Mexico, and Rhode Island. In Arizona, legislation sponsored by Representative Horton, known as H.B. 2603, was amended and passed by the House Committee on Banking and Insurance on February 1, 2000. This measure would require certain health and disability insurance carriers to provide equitable coverage for mental health conditions, including substance abuse treatment services.

The Kansas Senate Committee on Financial Institutions and Insurance sponsored a bill known as S.B. 547 on February 3, 2000. This measure would require certain health insurers to provide enrollees with coverage for specified mental health conditions. S.B. 547 was assigned to the Committee on the same day as its introduction.

In Massachusetts, legislation introduced during 1999 concerning insurance coverage of certain biologically based mental illnesses for active and retired Commonwealth employees, was addressed by the House Committee on Ways and Means on February 7, 2000. The Committee amended S.B. 2036 by inserting text from H.B. 5008 into the bill.

In New Mexico, two measures concerning mental health parity were addressed. H.B. 452, sponsored by Representative Sandoval was introduced on February 1, 2000. An amended version passed the House on February 7, 2000. S.B. 345, sponsored by Senator Mary Garcia was introduced on January 31, 2000 and assigned to the Senate Committees on Corporations and Transportation and Finance.

Representative Constantino, of Rhode Island, introduced H.B. 7444 concerning insurance coverage for substance abuse treatment services on February 3, 2000. This bill was assigned to the House Committee on Corporations.

The Uninsured

Action was taken in three states–Illinois, New Mexico, and West Virginia–concerning the uninsured. Senator Peterson, of Illinois, introduced S.B. 1675 on February 2, 2000. This measure, known as the Tobacco Settlement Proceeds for Affordable Health Insurance Coverage Act, would dedicate up to 25 percent of any revenues the state receives due to settlements of litigation with tobacco companies to a tax rebate for small-employers that provide high-risk employees with health insurance coverage. This measure was assigned to the Senate Rules Committee on February 2, 2000.

In New Mexico, Representative Valera introduced H.B. 165 on January 20, 2000, and it was referred to the House Committees on Consumer and Public Affairs and Appropriations and Finance on February 2, 2000. This bill would expand access to healthcare services for the under-served and indigent populations.

Delegate Kelley, of West Virginia, introduced the West Virginia Small Business Health Care Insurance Act (H.B. 4331) on February 1, 2000. This measure would create a program to allow small businesses to purchase health insurance for their employees through the state Public Employees Insurance Agency. H.B. 4331 would also require the state Public Employees Insurance Agency to develop a plan by January 1, 2002, to insure West Virginia residents who do not currently have health insurance coverage and meet other specified criteria.