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State Legislative Update

February 14 - March 10, 2000

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

Antitrust

Six more states—Alaska, California, Florida, New Jersey, Rhode Island and West Virginia—have taken action on bills to allow doctors to collectively bargain with health benefit plans. In Alaska, Senator Kelly introduced S.B. 256 on February 28, 2000. This bill, which would allow doctors to enter into joint negotiations over fee-based contractual provisions if a health plan was found to have substantial market power, passed the Senate Committee on Health Education and Social Services on February 24, 2000, as amended, and was assigned to the Senate Finance Committee.

Senator Jackie Spier of California introduced S.B. 2007 on February 25, 2000. This measure presumes that all third-party payers in the state have significant market power, and would allow physician coalitions to collectively bargain all patient care, clinical and reimbursement issues. Furthermore, S.B. 2007 would require carriers to finance any costs the state incurs due to the institution of physician collective bargaining through an assessment mechanism.

In Florida, Representative Lawson pre-filed H.B. 1589 on March 1, 2000. This bill, known as the Health Care Provider Joint Negotiation Act, would allow doctors to collectively bargain certain contractual matters, including fee-based matters under certain circumstances.

Two bills were introduced in New Jersey this reporting period, both of which are similar to antitrust legislation introduced last session. A.B. 2169, sponsored by Assembly Member Chatzidakis, and S.B. 1033 sponsored by Senator Bark, would allow physicians to collectively bargain with health benefit plans over certain contract provisions. Both measures were introduced on February 28, 2000, and S.B. 1033 was assigned to the Senate Committee on Health.

In Rhode Island, Representative Murphy introduced H.B. 7952 on March 1, 2000 and the measure was assigned to the House Committee on Corporations. This bill would authorize health care providers to collectively negotiate with health insurance carriers under specified conditions.

Finally, in West Virginia, H.B. 4604, which was sponsored by Representative Kiss at the behest of the Governor, was assigned to the House Committee on Government Organization on February 22, 2000. This bill would allow competing physicians to enter into joint negotiations with health benefit plans under specified circumstances.

Children's Health Insurance Program (CHIP)

Legislative action was taken concerning the Children’s Health Insurance Program (CHIP) in eleven states—Alabama, Arizona, Hawaii, Illinois, Indiana, Kentucky, Mississippi, Tennessee, Utah, Virginia, and West Virginia.

In Alabama, Representative Wren introduced H.J.R 100 on February 15, 2000 and it was sent to the House Committee on Rules. This bill would reestablish the CHIP commission. The commission would be required to study CHIP and determine how to provide for the health care needs of low-income children that are not eligible for Medicaid.

Senator Solomon of Arizona introduced S.B. 1158 on January 10, 2000 and it was referred to the Senate Committee on Health where it passed with an amendment. This bill was then sent to the House Committee on Rules. This bill would amend eligibility requirements for the CHIP program to allow persons to receive services on the first day of the month, which the person applied for eligibility.

Also in Arizona, Senator Gnant introduced S.B. 1180 on January 12, 2000. It is now pending before the Senate Committee of the Whole. This bill would eliminate the six-month waiting period for eligibility under the CHIP program for people with previous health care coverage. The Director of the Arizona Health Care Cost Containment System would be required to study the extent to which CHIP is being used as a substitute for other available coverage. The Director would have to submit a report on the study by Nov. 15, 2001.

In Hawaii, Representative Arakaki introduced H.B. 540 on January 22 2000. This bill was then referred to the House Committee on Human Services where it passed as amended. It then passed the House with the Committee amendment. This bill would appropriate funds for health insurance for immigrant children and would expand Hawaii’s Medicaid program.

In Illinois, Senator Madigan introduced S.B. 3583 on January 24, 2000. This measure was referred to the House Committee on Rules and then to the House Committee on Executive. It would amend the CHIP Act and make a technical change in provisions regarding funding for the program.

Also in Illinois, Representative Daniels introduced H.B. 4212 and it was referred to the House Committee on Rules and the House Committee of the Executive on February 3, 2000. This bill would amend the CHIP Act and make a technical change in a section concerning the legislative intent of the Act.

Senator Miller of Indiana, introduced S.B. 504 on January 10, 2000. An amended version of this bill passed the Senate. It was then sent to the House Ways and Means Committee where it passed as amended. The Committee amendment was adopted on the House floor and sent to the Senate where they concurred with the House amendments. S.B. 504 defines an emergency for purposes of CHIP and prohibits cost sharing under CHIP for emergency services provided within a hospital emergency department.

In Kentucky, H.B. 628 was introduced on February 9, 2000. This bill would establish premiums and copayments for the CHIP program, and would limit the cost-sharing maximum. It would also require the Cabinet for Health Services to establish non-Medicaid health insurance or health coverage for certain low-income children.

In Tennessee, H.B. 3230 was introduced and referred to the House Committee on Government Operations on February 7, 2000. The bill would enact the 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 passed the House and were sent to the Senate. 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 Master Tobacco Settlement of 1998 for CHIP.

Also in Utah, Senator Montgomery introduced S.B. 45 on January 21, 2000 and it was sent to the Senate Committee on Human Services where it failed to pass and then sent to the Senate Committee on Rules. The bill requires that the hospital provider assessment be reduced to the extent tobacco settlement monies are appropriated for the CHIP program. It appropriates funds from the tobacco settlement account for fiscal year 2000-2001.

Virginia lawmakers recently took action on several bills related to CHIP. Delegate Baskerville introduced H.J.R. 274 on January 24, 2000, which was referred to the House Committee on Rules where it died in Committee. This bill would have requested a joint subcommittee to examine the current 12-month waiting period for those children eligible for CHIP but, were previously covered or dropped by another insurance plan.

Delegate Brink introduced H.B. 366 on January 12, 2000. The bill was sent to the House Committee on Health, Welfare and Institutions, where it died in committee. The bill addressed the Virginia Children’s Medical Security Insurance Plan. It would have required certain outreach programs, including Virginia’s Title XXI plan, to provide for coordinated implementation of publicity, enrollment and service delivery with existing local programs throughout the Commonwealth that provide medical services, education services, and case management services to children.

Also in Virginia, Senator Lambert introduced S.B. 727 on January 24, 2000. The bill was referred to the Committee on Education and Health and will be continued to the 2001 legislative session. The bill would require the state Board of Medical Assistance Services to ensure that all contracts for implementation of CHIP, and all contracts for the implementation of managed care include testing of children for elevated blood lead levels in accordance with the regulations promulgated by the Board of Health.

In West Virginia, Representative Compton introduced H.B. 4489 on February 10, 2000. The bill passed the House Committee on Government Organization as substituted. The bill would create the children’s health insurance agency, which would take over control of the CHIP program from the Department of Health and Human Services.

Representative Prezioso of West Virginia introduced S.B. 565 on February 21, 2000. The bill passed the Senate Committee on Health and Human Resources and the Senate Committee on Finance as substituted. The bill transfers the CHIP program to the Department of Administration. S.B. 565 would amend state CHIP statutes to increase the amount of children enrolled by implementing new eligibility requirements.

Confidentiality of Medical Records

In Hawaii, H.B. 2004, sponsored by Representative Menor, was referred to the House Committee on Finance on February 18, 2000. H.B. 2004 would require the state Director of the Office of Information Practices to proceed with legal action against a person that breaks the confidentiality of an individual’s medical records. Each violation may result in a maximum of a $500 fine, with the total fine not to exceed $5000.

H.B. 2914, introduced by Representative Findley in Kansas, was referred to the House Committee on Insurance on February 10, 2000. This bill is known as the Health Information Privacy Act, and would apply to health plan carriers and those that manage health information. The carrier must develop a written policy of standards for the management of enrollees’ health information to guard against the unauthorized use, or disclosure of the information. The written policy must be delivered to the state insurance commissioner. Plan enrollees also have the right to receive a copy of their own health information that is kept by the carrier.

Representative Johnson in Minnesota introduced S.F. 2866. This bill was referred to the Senate Committee on Health and Family Security on February 10, 2000. This act would amend an existing Minnesota statute that relates to health data privacy. A patient must give prior consent to a health plan for the release of any patient identifying data.

Also in Minnesota, a bill similar to S.F. 2866 was introduced in the House. Representative Lenczewski introduced H.F. 3749 on February 21, 2000 and it was then referred to the House Committee on Health and Human Services Policy.

On February 22, 2000 in South Dakota, H.B. 1175 was sent to the Governor’s office to be signed into law. This act, sponsored by Representative Hunt, 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.

H.B. 603 was referred to the Conference Committee in Virginia on February 25, 2000. Representative McQuigg sponsored this measure. This measure would require that a cancer patient who is part of a statewide registry be notified when his/her identifiable medical information is used in a statewide report.

In Washington, S.B. 6684 sponsored by Senator Ihibaudeau, was sent to the Senate Committee on Health and Long-Term Care on January 24, 2000. This bill would prohibit the disclosure of health care information about a patient. For those who violate the confidentiality requirements, a fine of $1000 or the cost of actual damages, whichever is greater, would be imposed. Attorney’s fees and any other relief costs could also be demanded. Consolidated Omnibus Budget Reconciliation Act of 1983 (COBRA) Federal and state legislative activity occurred recently on matters related to the

Consolidated Omnibus Budget Reconciliation Act of 1983 (COBRA)

H.B. 3631 was introduced by Representative Kleczka and was referred to the House Ways and Means Committee, the House Commerce Committee and the House Education and the Workforce Committee on February 10, 2000. This bill would allow retirees 55 to 65 years of age who lose employer-based coverage to acquire health care coverage under the Medicare Program or under COBRA continuation benefits.

In Connecticut, S.B. 532 was introduced and then referred to the Committee on Public Health on February 29, 2000. This bill would extend the period of health insurance portability and provide extended health insurance coverage to individuals that have exhausted their benefits under COBRA.

In Virginia, S.B. 302 was introduced by Senator Reynolds on January 19, 2000, and was reported out favorably from the Senate Committee on Education and Health. This bill would require the state Board of Medical Assistance Services to include in the state Medicaid program, an option to provide Medicaid eligibility to qualified COBRA continuation beneficiaries. A program for displaced workers, which is similar to the federal option for qualified COBRA continuation beneficiaries would also be established by this bill.

Genetic Discrimination

Action was taken on genetic discrimination in five states—California, Idaho, Iowa, New York and Rhode Island. In California, Assembly Member Papan introduced legislation to prohibit any insurance producer or underwriter from disclosing any individually identifying information about a customer’s health, or medical or genetic history. This bill, S.B. 2792, was introduced on February 28, 2000.

Also in California, S.B. 1364 sponsored by Senator Johnston passed the Senate Committee on Judiciary on February 29, 2000. This bill amends the Confidentiality of Medical Information Act by defining genetic characteristics. Genetic characteristics would have the same meaning as in the California Health and Safety Code which is: (1) any scientifically or medically identifiable gene or chromosome, or combination or alteration thereof, that is known to be a cause of a disease or disorder in a person or his or her offspring, or that is determined to be associated with a statistically increased risk of development of a disease or disorder, and that is presently not associated with any symptoms of any disease or disorder; or (2) inherited characteristics that may derive from the individual or family member, that are known to be a cause of a disease or disorder in a person or his or her offspring, or that are determined to be associated with a statistically increased risk of development of a disease or disorder, and that are presently not associated with any symptoms of any disease or disorder.

The Idaho Senate Committee on State Affairs introduced a bill on February 24, 2000 that would prohibit life and health insurers, as well as employers, from discriminating against individuals on the basis of their genetic information. This measure was assigned to the committee on February 25, 2000.

Senator Hammond, of Iowa, introduced S.F. 2305 on February 23, 2000. This bill, which was assigned to the Senate Committee on Human Resources, would prohibit insurers from discriminating against enrollees when issuing renewals based on certain types of genetic information and would establish a penalty for violators.

In New York, a bill introduced by Senator Skelos during the 1999 session that would prohibit insurers from refusing to issue or renew certain life and disability policies based on a person’s genetic susceptibility to any type of cancer, passed the Senate on February 29, 2000. S.B. 968 was assigned to the Assembly Committee on Insurance that same day.

Two measures are pending in Rhode Island, S.B. 2535 sponsored by Senator Felag and S.B. 2599 by Senator Graziano. Both would prohibit certain insurers from requiring the use of genetic testing and have been pending in the Senate Committee on Corporations since February 10, 2000.

Health Insurance Tax Incentives

Senator Smith in Connecticut introduced S.B. 257 on February 15, 2000, and it was then referred to the Joint Committee on Finance, Revenue and Bonding. A similar bill, H.B. 5399, sponsored by Representative Cocco, was also referred to the Joint Committee on Finance, Revenue and Bonding on February 15, 2000. These bills would amend an existing Connecticut statute to allow a tax deduction from an individual’s taxable income for medical expenses.

In Georgia, H.B. 1525, sponsored by Representative Harbin, was referred to the House Committee on Ways and Means on February 17, 2000. This bill would amend an existing state law to allow a taxpayer a credit against his/her income tax. The amount of the credit could not exceed 50 percent of the total amount spent for health insurance premiums for the taxpayer or for an individual related to the taxpayer by blood, marriage or adoption. The credit could not exceed $2,000, or the individual’s income tax liability, whichever is less.

The House Committee on Taxation and Revenue introduced H.B. 707 in Idaho on March 3, 2000. This bill would create a tax deduction for taxpayers that are self-employed. The deduction would be equal to the amount the taxpayer paid for insurance premiums to cover the taxpayer, his/her spouse and/or dependents. The deduction may not be greater than three percent of the taxpayer’s total investments.

H.B. 813 was introduced by Representative Crall and then referred to the House Committee on Appropriations and Revenue in Kentucky on February 25, 2000. An existing Kentucky act relating to income tax would be amended to allow a tax deduction from an individual’s gross income. Individuals, who use a voucher to provide health insurance coverage for themselves, a spouse or/and dependents would be granted a tax deduction that is equal to the amount of the voucher.

In Maine, H.P. 1613 passed the House and on February 29, 2000 it was placed on the Special Appropriations Table. This bill, sponsored by Representative Gagnon, is designed to match the tax laws in Maine to the United States Internal Revenue Code in regard to a health insurance tax deduction for self-employed individuals.

In New Mexico, Senator Jennings sponsored S.B. 373 and it was referred to the Senate Committee on Finance and the Senate Committee on Ways and Means on February 1, 2000. This bill would provide a tax deduction to individuals with certain unreimbursed or uncompensated medical care costs. This bill amends the New Hampshire Income Tax Act. The tax deduction could be claimed against an individual’s net income for all medical care expenses for which the individual was not compensated. The amount of the tax deduction depends on the total income tax filing of the individual.

S.B. 2771 was introduced and sent to the Senate Committee on Finance on February 10, 2000 in Rhode Island. Senator Badeau sponsored this bill, which relates to personal state income tax and would allow taxpayers a deduction for health insurance premium costs. The deduction would be equal to the amount spent by the individual on insurance premiums but could not exceed $5,000.

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

Legislative action was taken on measures concerning the Health Insurance Portability and Accountability Act of 1996 (HIPAA) in Hawaii and Maryland. In Hawaii, Representative Hiraki and Senator Taniguchi introduced H.B. 2707 and S.B. 2292 on January 27, 2000 and January 21, 2000 respectively. H.B. 2797 was amended in the House Committee on Consumer Protection and passed the House as amended. S.B. 2292 was sent to the Senate Committee on Commerce and Consumer Protection and the Senate Committee on Health and Human Services where it passed with an amendment. Both of these measures require group and individual health insurance carriers to comply with the federal HIPAA requirements.

In Maryland, H.B. 91 passed the House with an amendment and was then sent to the Senate Committee on Finance. This bill would require special enrollment periods for certain group health plans and HMOs. This bill would also change when a carrier could cancel or refuse to renew a health benefit plan for a small group, and would require enrollee notification of certain coverage changes.

Also in Maryland, on January 4, 2000, S.B. 53 was amended in the Senate Committee on Finance and passed the Senate with the amendment. The legislation was then referred to the House Committee on Economic Matters. This bill is similar to H.B. 91.

Health Plan Liability

In Arizona, S.B. 1168 introduced by Senator Cunningham was referred to both the Senate Committee on Financial Institutions and Retirements and the Senate Committee on Rules on January 18, 2000. This bill would amend an existing state law with regard to health care insurance claims. Sections would be added to include a provision that any insured may be entitled to file a civil claim under common law for the suffering or harm caused as a result of violations by the health care insurer.

Also in Arizona, S.B. 1061, sponsored by Senator Day, would amend existing law concerning the health care appeals process by changing requirements for independent medical reviews. In addition, S.B. 1061 would establish a fund, to be administered by the state Department of Insurance, to reimburse independent medical review organizations for their services. Monies for the fund will be collected by the state from the health insurers of individuals who have initiated the appeals process. This act passed the Senate on February 28, 2000 and has been sent to the House.

The Connecticut Committee on Judiciary introduced S.B. 511 on February 28, 2000. A managed care organization would be required to exercise ordinary care when making a health care treatment decision for an enrollee. The enrollee would be able to file civil actions against the organization to recover damages for personal injury or harm that is caused when the HMO fails to exercise ordinary care. The internal review and appeals process must be exhausted before any civil action may go forward by the enrollee. Civil action may not be brought against the enrollee’s employer that offered the health plan unless the employer made the health care treatment decision that resulted in the enrollee’s injury or death.

In Iowa, S.F. 2306 sponsored by Senator Connolly was referred to the Senate Committee on Commerce on February 29, 2000. This bill would state that a managed care entity or HMO is liable for injury to an enrollee when ordinary care is not exercised in making health care treatment decisions.

Representative Findley in Kansas introduced H.B. 2963, which would establish the managed care responsibility act. This act was referred to the House Committee on Insurance and the House Committee on Judiciary on February 10, 2000. A health insurer would have the duty to exercise ordinary care when making health care treatment decisions and could be held liable for damages or harm caused by the failure to exercise ordinary care to the insured. An employer that offered the enrollee the insurance could not be held liable for any damages that were caused by the health plan’s treatment decision. Before filing a civil cause of action, the enrollee must exhaust the appeal and review process and give written notice of the claim to the health carrier.

In Maryland, Representative Elliott introduced H.B. 814 on February 11, 2000. This act would establish the liability of an insurer or health service plan for certain costs like attorney’s fees, and damages if the insurer or plan is found to have engaged in unfair practices. The punitive damages the health plan must pay may not exceed $100,000 or double the amount of actual economic losses.

Also in Maryland, H.B. 943 was introduced by Representative Zirkin and then sent to the House Committee on Economic Matters on February 11, 2000. This act would establish the liability of certain health plan carriers and managed care entities for damages that an enrollee suffers as a result of health care treatment decisions made by the carrier or a representative of the carrier. Ordinary care must be exercised when making health care treatment decisions for the insured.

Representative Mullery in Minnesota introduced H.F. 3955 on February 28, 2000. This bill was then referred to the House Committee on Health and Human Services Policy. Liability would be established for health decisions that an HMO makes with regard to an enrollee’s health care treatment. A licensed physician must be the medical director of the health plan and make all treatment and utilization review decisions. The standards the medical director must follow to make a treatment decision must be based on the generally accepted standard of health care practices among other HMOs, or the general accepted practice among the medical community. If the medical director does not exercise ordinary care when making treatment decisions, he or she could be found liable for any injury or harm incurred by the insured.

In New Jersey, Assembly Member Kelly introduced A.B. 2055 on February 10, 2000. This act would make health insurance carriers liable for medical malpractice. Consumers would be able to sue their health insurance carrier for medical malpractice. Consumers must exhaust all appeal and review processes and provide written notice of the intended action against carrier before any action can proceed. Consumers would be exempt from these rules if harm or death has already occurred as a result of the health plan’s treatment decisions.

Senator Velella in New York sponsored S.B. 38, which was amended in the Senate Committee on Judiciary on March 1, 2000. This bill would hold health care organizations responsible for decision delays, failures or refusals of health service for which the health plan is contractually responsible. The health care organization would also be liable for damages or death that may occur. An HMO or health care organization may not offer an incentive program to providers that delay or refuse to provide health care services. The health plan or HMO must exercise reasonable care when making decisions that affect treatment.

In Rhode Island, H.B. 6901 sponsored by Representative Henseler, is a Joint Resolution to extend the reporting date of a special legislative commission investigation to study the status of health care and HMO liability from January 25, 2000 to September 26, 2000. This resolution passed the house and on January 27, 2000 was adopted by the Senate.

Also in Rhode Island, Senator Graziano introduced S.B. 2229 on February 2, 2000, and it was referred to the Senate Committee on Corporations. This measure states that an HMO or managed care entity must exercise ordinary care when making health care treatment decisions. The HMO or entity would be liable for damages when a failure in exercising ordinary care occurs. Before an enrollee may file legal action the review and appeals process must be exhausted, unless harm or injury has already occurred.

Representative McEachin introduced H.B. 92 in Virginia, and on January 27, 2000 it died in the House Committee on Courts of Justice. This measure would have provided that a health plan must exercise ordinary care in its decision process for an enrollee’s health care treatment. Ordinary care is the degree of care that other health plans would use in similar health care treatment situations. The health plan would have been liable if injury was caused to an enrollee because of decisions made by the plan’s employees, agents, or representatives.

Representative Edwards introduced S.B. 287 in Virginia. This measure was referred to the Senate Committee on Courts and Justice and on February 15, 2000 it died in the committee. S.B. 287 would have established that a health insurance carrier must exercise ordinary care in making healthcare treatment decisions. The carrier would have been held liable for damages arising from injury or death caused by its healthcare treatment decisions.

Health Purchasing Cooperatives

In Minnesota, two similar bills relating to health purchasing cooperatives had recent legislative activity. H.F. 3375, sponsored by Representative Mulder, passed the House Committee on Health and Human Services and was then referred to the House Committee on Commerce on February 28, 2000. S.F. 3161, sponsored by Senator Kiscaden, was introduced and then referred to the Senate Committee on Health and Family Security on February 14, 2000. Both bills would amend a Minnesota statute that relates to health care purchasing alliances. H.F. 3375 and S.F. 3161 would allow qualifying employers to participate in a health care alliance with other employers without it affecting the employer’s standing under the Employee Retirement Income Security Act of 1974 (ERISA).

High-Risk Health Insurance Pools

In Arizona and Mississippi, legislation is pending concerning high-risk health insurance pools. Arizona Senator Grace has introduced legislation that would create a high-risk pool in the state. The pool would be financed by an assessment on health insurance carriers, and would allow carriers a premium tax credit to help offset costs. This measure passed the Senate Health Committee with an amendment on February 8, 2000.

Mississippi legislators are considering several measures that would make changes to the state’s existing health insurance risk pool. H.B. 915, sponsored by Representative Evans, would revise the eligibility requirements for coverage in the state’s pool. This bill is currently pending before the House Committee on Insurance.

Also in Mississippi, Senator Kirby sponsored a bill, S.B. 2999, which would prohibit an assessment on insurance carriers from being used as the funding mechanism for the state’s high-risk pool. This measure was introduced on February 21, 2000 and assigned to the Senate Committee on Insurance.

Finally, Mississippi S.B. 3094 would establish that coverage provided by the state’s high-risk insurance pool must be as least as comprehensive as the coverage provided by the state’s public employee health insurance plan. This bill would also increase the maximum benefit limit for pool participants. S.B. 3094 was sponsored by Senator Burton and assigned to the Senate Committee on Insurance on February 21, 2000.

Long-Term Care

Fourteen states—Alabama, California, Connecticut, Hawaii, Indiana, Kansas, Maryland, Minnesota, Mississippi, Missouri, New Jersey, Oklahoma, Virginia and West Virginia—addressed measures relating to long-term care insurance. In Alabama, H.B. 170 and S.B. 187 are both known as the Long-Term Care Insurance Policy Minimum Standards Act. These bills would provide for the regulation of long-term care insurers by the state Commissioner of Insurance. H.B. 170 passed the House on February 24, 2000, and is currently pending in the Senate Health Committee. S.B. 187 passed the Senate Committee on Banking and Insurance as amended on February 10, 2000.

Assembly Member Alquist, of California, introduced A.B. 2281 on February 24, 2000. This bill would allow taxpayers to deduct a percentage of the amount they spent during the taxable year for the cost of long-term care insurance for themselves, a spouse or a dependent from their state income tax liability.

Connecticut lawmakers are considering two long-term care tax incentive bills. H.B. 5001, introduced by the House Committee on Aging, would allow individuals a tax credit equal to 50 percent of their annual long-term care insurance premiums. This measure was assigned to the Joint Committee on Finance, Revenue and Bonding on March 1, 2000. Connecticut H.B. 5242, sponsored by Fahrbach, is also pending before the Joint Committee on Finance, Revenue and Bonding. This bill would allow individuals to deduct their long-term care insurance premium costs from their state income tax liability.

In Hawaii, a measure sponsored by Representative Arakaki would appropriate funds from the emergency budget reserve fund to a special fund to subsidize a portion of long-term care insurance premiums for individuals over age 65 on a sliding-scale basis.

Legislation in Indiana sponsored by Senator Miller passed the Senate on February 7, 2000 and was assigned to the House Ways and Means Committee. S.B. 319 would establish a voluntary program that would allow all state employees to purchase qualified group long-term care coverage. The state would be required to pay 20 percent of each employee’s premium costs.

Kansas H.B. 2835 was introduced by Representative Findley on February 2, 2000. This measure, which was assigned to the House Committee on Taxation on February 3, 2000, would allow individuals to deduct their long-term care insurance premiums from their state income tax liability.

Maryland Delegate Al Redmer introduced a bill on February 11, 2000 that was heard before the House Ways and Means Committee on March 10, 2000. This bill would allow individuals a state income tax credit of up to $500 for long-term care insurance premium costs for themselves, a spouse, parent, stepparent, child or stepchild.

In Minnesota, six measures are pending—H.F. 3044, H.F 3089, H.F. 3632, S.F. 2971, S.F. 2975 and S.F. 3677. H.F. 3044, sponsored by Representative Dehler, H.F. 3089, sponsored by Representative Tomassoni, S.F. 2971, introduced By Senator Lourey and S.F. 2975, sponsored Senator Fischbach, all would make amendments to the state’s existing long-term care income tax credit.

Also under consideration in Minnesota are two identical measures known as H.F. 3632 and S.F. 3677 that were introduced by Representative Haas and Senator Oliver respectively. These bills would make changes to the existing state advisory committee concerning providing long-term care insurance to state employees. H.F. 3632 passed the House Committee on Governmental Operations and Veterans Affairs on March 2, 2000 and was assigned to the House Committee on State Government Affairs. S.F. 3677 is currently pending in the Senate Committee on Government Operations and Veterans Affairs.

Representative Barnett of Mississippi introduced a measure on March 1, 2000 that would provide individuals with an income tax credit for the amount they pay for long-term care insurance premiums. H.B. 1568 is pending before the House Ways and Means Committee.

In Missouri, H.B. 1737 was adopted on the House floor on February 29, 2000. This bill, which was sponsored by Representative Monaco, would require long-term care insurance policies to include information identifying the policy as either tax-qualified or non-tax-qualified. The bill would also require the state Insurance Commissioner to include in its long-term care consumer guide information about the tax consequences associated with different types of insurance policies.

Another bill was introduced in New Jersey to give businesses a tax credit for providing employees with long-term care insurance benefits. S.B. 945 was sponsored by Senator Singer on February 10, 2000 and is currently pending before the Senate Committee on Health.

Oklahoma lawmakers are currently considering S.B. 1425, a bill to exempt the amounts individuals pay for long-term care insurance premiums from state income tax liability. This measure, which was introduced by Senator Henry, is pending before the Senate Finance Committee.

In Virginia, three long-term care bills are awaiting the Governor’s signature. H.B. 1458 and S.B. 517, introduced by Representative Morgan and Senator Forbes, are similar bills that would allow local government and school board employees to participate in a voluntary long-term care insurance program made available to them by the state Department of Personnel and Training.

Also pending approval by the Governor in Virginia is H.B. 1511. This bill, which was also sponsored by Representative Morgan, would establish limits on the contestability periods for long-term care insurance.

Finally, in West Virginia, two similar bills are pending. S.B. 404, sponsored by Senator Helmick and H.B. 4354, sponsored by Representative Cann, would both allow individuals to deduct their long-term care insurance premiums from their federal taxable income when determining state income tax liability. H.B. 4354 passed the House on February 25, 2000 and is now being considered by the Senate Finance Committee. S.B. 404 is pending before the Senate Committee on Banking and Insurance.

Managed Care Reform/Patient Protection

In Colorado, Senator Wattenberg sponsored S.B. 95, which on February 24, 2000 passed the Senate and was then assigned to the House Committee on Health, Environment, Welfare and Institutions. This bill would require a health plan that covers any eye care services to give an enrollee direct access to any eye care provider that is a participant in the health plan. A referral from the individual’s primary care physician would then not be required.

The Committee on Insurance in Connecticut introduced S.B. 49 on February 9, 2000. This bill would prohibit financial incentives from a managed care organization to a health care provider based on that provider’s treatment decisions.

S.B. 432 in Georgia passed the Senate and was sent to the House on February 28, 2000. Senator Polak sponsored this act which would amend an existing state law relating to insurance. S.B. 432 would require those individuals that make treatment decisions to posses either a bachelors or higher degree in any health related field that specified by the state Insurance Commissioner.

Also in Georgia, S.B. 475 was introduced and sent to the Senate Committee on Insurance and Labor on February 21, 2000. The sponsor of this bill is Senator Thomas. Existing state laws relating to managed care organizations would be amended. The organizations could not, through any type of incentive program, prohibit or restrict a physician from providing treatment that is medically necessary and covered under the plan.

S.F. 2237, that was formerly Senate study bill 3026 in Iowa, was introduced and referred to the Senate on February 22, 2000. The Committee on Commerce sponsored this bill, which would establish that under an HMO contract, podiatrists would be compensated for any care and treatment sought by an HMO enrollee.

In Kansas, the Committee on Health and Human Services introduced H.B. 2887 on February 8, 2000. Health insurers and managed care organizations would not require an enrollee to obtain prior authorization before accessing an emergency medical system for emergency care. Under the act, emergency care is needed when the enrollee is in an emergency condition. This is defined as when a layperson would believe that a patient’s health is in serious jeopardy, serious impairment of bodily functions could occur, or serious dysfunction of a bodily organ could result from not obtaining care.

In Maryland, H.B. 669 sponsored by Representative Goldwater was introduced and sent to the House Committee on Economic Matters on February 10, 2000. This bill amends existing state law to allow a woman greater access to obstetrical or gynecological care. Health Maintenance Organizations (HMOs) would provide the same benefits and coverage to a woman receiving care from a certified nurse midwife or any other authorized provider of obstetric or gynecological services, as they would to a certified obstetrician or gynecologist under the individual’s health plan.

Also pending in Maryland is H.B 1016, which was introduced by Representative Hurson and then sent to the House Committee on Economic Matters on February 11, 2000. Certain insurers and HMOs would be prohibited from making benefit treatment decisions for certain diseases or ailments subject to different copayment amounts, deductibles, or maximum limits then other diseases or ailments.

Minnesota had three bills regarding managed care reform with recent legislative activity. The first two bills are similar. H.F. 2876 was introduced by Representative Orfield and sent to the House Committee on Health and Human Services Policy on February 3, 2000. S.F. 2899 was introduced by Senator Marty and sent to the Senate Committee on Health and Family Security on February 10, 2000. These bills establish patient protection measures in Minnesota. A health care provider would not be allowed to enter into a financial incentive program with a health plan organization to restrict treatments to the health plan’s enrollees. If an enrollee was receiving ongoing treatment for a terminal or life threatening condition from a health care provider who is no longer covered under the enrollee’s new health plan, treatment could still continue with the enrollee’s choice provider. A health plan must also provide a clear statement of all policy and procedures to all enrollees of the health plan

The third bill in Minnesota, S.F. 3156, was introduced and referred to the Senate Committee on Commerce on February 14, 2000. Senator Berglin sponsored this act, which is similar to S.F. 2899 in providing patient protection measures, but it also provides coverage for clinical trials. S.F. 3156 allows enrollees to seek treatment for a life threatening disorder, early detection or treatment of cancer through clinical trials.

In Mississippi, Senator Jordan introduced S.B. 3114 on February 21, 2000 and it was referred to the Senate Committee on Public Health and Welfare. This act would amend existing state law regarding to prior authorization for emergency care. Emergency care benefits would be covered without regard to prior authorization and whether or not a non-participating provider provides services when an enrollee is in an emergency medical condition. Emergency medical condition is defined as a condition that a lay person could reasonably expect would place the individual's health in serious jeopardy.

In New Hampshire, Senator Wheller sponsored S.B. 147. This bill passed both the House and the Senate, and on February 18, 2000 the Governor signed it into law. This measure addresses self-referrals for chiropractic care. An individual may have 12 self-referral visits to a chiropractor. After the 12 visits, a utilization review by the health plan may be conducted to allow for the continuity of care.

On February 17, 2000 in New Hampshire, H.B. 640 sponsored by Representative Hunt passed the Senate and then the House concurred to all the Senate’s amendments. This act would create an independent external review process for consumer appeals regarding a health plan’s treatment decisions.

In New York on February 10, 2000, Senator Balboni introduced S.B. 6504 and it was immediately referred to the Senate Committee on Insurance. This act would amend existing insurance law in the state when health care treatment has been denied. If a claim for coverage of treatment is denied, it must either be because the treatment is not medically necessary or because the treatment is not effective. The enrollee must be informed of what alternative treatment is covered by the health plan and proof of past ineffectiveness of the desired treatment.

Senator Kelly in Rhode Island introduced S.B. 2696 on February 10, 2000. This bill was then referred to the Senate Committee on Corporations. This act would protect health plan enrollees against HMO insolvency. An HMO must deposit in the general treasury of the state, securities equal to the market value of five percent of the estimated expenditures of the organization, twice it’s average monthly uncovered expenditures, or $100,000 whichever is the greatest amount. If the state Director of Insurance finds that the organization has failed to do so or has not maintained the treasury account, the HMO must file a written plan of correction within 60 days of the deficiency.

In Utah, S.B. 95 sponsored by Senator Knudsen passed the Senate on January 25, 2000 and passed the House on February 10, 2000. This act would allow enrollees in rural areas to obtain health care services from a non-contracting provider that is closer in distance then any other provider. The enrollee must reside in an area with a population density of less than 100 people per square mile.

Three bills in Virginia had recent legislative activity. H.B. 915 sponsored by Representative Cranwell died in the House Committee on Corporations, Insurance, and Banking on February 8, 2000. This measure would have amended current law regarding managed care health insurance plans. Individuals that are covered under a managed care plan would have been allowed to select the health care provider of their choice, whether provider is in or out of network. An out-of network provider could agree to accept payment for services that are imposed by the individual’s plan.

H.B. 1425 sponsored by Representative Griffith also died in Committee on Corporations, Insurance and Banking on February 8, 2000. This measure would have amended current law regarding managed care health insurance plans. A health care plan would had to accept as a participating provider any hospital that was willing to accept reimbursement for services, rates that the HMO had accepted by other hospitals in a 75 mile radius.

On February 22, 2000 also in Virginia, S.B. 73, which Senator Colgan sponsored, became eligible for the Governor’s desk to be signed into law. This act would add a new section to existing state codes relating to HMOs. The new section would require HMOs to initially deposit no less than $300,000 into a state treasury account to be held in case the HMO becomes insolvent. The Insurance Commissioner would then decide whether the account must be increased, decreased or returned to the HMO depending on the organization’s assets and condition.

In Washington, S.B. 5776 was referred to the Senate Committee on Ways and Means on February 4, 2000. Senator Franklin sponsored this bill. The measure would require certain health insurance carriers to allow each enrollee direct access to a participating chiropractor of the enrollee’s choice. Also in Washington, H.B. 2331 sponsored by Representative Campbell passed the House and was referred to the Senate Committee on Health and Long-Term Care on February 16, 2000. This measure was created to ensure that patients who are covered by health plans receive quality health care. This act would ensure that enrollees: (1) have access to information regarding their health plans; (2) have a broader choice among health care providers; (3) have access to a quick and impartial appeals process of a plan’s health related decision; and (4) are ensured the privacy of their medical information.

Mandated Benefits

Cancer-related Mandates: Four states—Arizona, Indiana, Maryland and New York—addressed legislation concerning mandating coverage for screening or treatment services. In Arizona, Representative Leff introduced a measure that would require certain specified health insurers to provide coverage for drugs used to treat cancer. (The measure also mandates coverage of chiropractic services.) On February 28, 2000, H.B. 2600 passed the Senate Rules Committee.

Indiana H.B. 1293 was sponsored by Representative Ruppel, and the measure passed the Senate as amended on February 28, 2000. This bill would require managed care organizations that provide coverage to state public employees to cover all colorectal cancer screening services and related laboratory tests.

Senator Teitelbaum, of Maryland, also introduced a bill to require specified types of health plans to provide enrollees with coverage of colorectal cancer screening tests according to guidelines established by the American Cancer Society. S.B. 174 passed the Senate on February 29, 2000, and was assigned to the House Committee on Economic Matters on March 1, 2000.

In New York, Senator Kruger sponsored legislation that would prohibit deductible requirements for cervical cancer screening services and mammography screening. This measure also includes provisions to extend the eligibility requirements for mammography coverage. S.B. 6586 was introduced on February 16, 2000 and it was assigned to the Senate Committee on Insurance.

Clinical Trial Mandates: Legislation concerning coverage of participation in clinical trials was considered in Arizona, California, Connecticut, Georgia and Minnesota. In Arizona, mandate legislation introduced by Senator Day passed the Senate on February 8, 2000 and was assigned to the House Committees on Health, Rules and Banking and Insurance on February 21, 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.

Senator Jackie Speir, of California, introduced S.B. 1839 on February 24, 2000. This measure, which was assigned to the Senate Insurance Committee on March 2, 2000, would require specified health and disability insurers to provide enrollees with coverage of routine patient care costs associated with participation in certain clinical trials for the treatment of life-threatening prostate cancer. This measure would take effect after January 1, 2001, and carriers would be required to annually submit a report to the state Insurance Commissioner concerning the enrollees who received coverage through this mandate.

In Connecticut, the Senate Committee on Insurance introduced clinical trial legislation on March 2, 2000. S.B. 580 would require certain health insurers to provide coverage for all costs of any procedure or treatments associated with the participation in a clinical trial for the treatment of cancer, that is not covered by the sponsoring pharmaceutical company. Pharmaceutical companies would be required to cover those costs that are ordinarily associated with the research and development of the drug in question. This measure was assigned to the Joint Committee on Insurance and Real Estate on March 2, 2000.

Georgia Representative Henson introduced H.B. 1640 on March 1, 2000. This bill, which was assigned to the House Committee on Insurance, would prohibit certain health insurance carriers from excluding certain patient care costs associated with adults participating in approved clinical trial programs for cancer treatment from the scope of coverage.

In Minnesota, Senator Berglin’s bill, S.F. 3156, would also require certain health insurers to provide their enrollees with coverage of specified costs associated with participation in approved clinical trials. This bill passed the Senate Committee on Health and Family Security on March 1, 2000, and was referred to the Senate Commerce Committee on the same date.

Drug-related Mandates: Lawmakers in five states—Florida, Kansas, New Jersey, South Dakota and Virginia—addressed legislation that would mandate coverage of specific types of prescription drugs. In Florida, H.B. 1469, sponsored by Representative Edwards, was pre-filed on February 24, 2000. This measure was assigned to the House Interim Committees on Health Care Services, Insurance, Governmental Operation and General Government Appropriations on March 6, 2000. H.B. 1469 addresses drug formularies, and it would prohibit certain health insurance carriers and HMOs from excluding coverage for certain types of prescription drugs.

The Kansas Senate’s Committee on Financial Institutions and Insurance introduced S.B. 523 on January 31, 2000. This bill was re-assigned to that committee on February 23, 2000 and it would prohibit certain health insurers from limiting reimbursement for maintenance drugs to a 90-day supply.

In New Jersey, Assembly Member Murphy filed A.B. 2167 on February 25, 2000. This bill would require certain health insurance carriers to provide enrollees with coverage of prescription contraceptives.

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, was passed by the state legislature on February 23, 2000 and was sent to the Governor for signature.

Senator Couric, of Virginia, introduced S.B. 284 on January 18, 2000. This bill would prohibit certain health insurance carriers from refusing to cover a specific prescription drug based on the length of time that had passed since the drug received FDA approval. S.B. 284 passed the Virginia legislature on February 28, 2000 and is currently awaiting signature by the Governor.

Infertility Mandates: Six states—California, Connecticut, Florida, New Jersey, Oklahoma and Virginia—took action on legislation mandating coverage for the diagnosis and/or treatment of infertility. In California, Senator Hayden sponsored legislation on February 22, 2000. S.B. 1630 would require certain carriers of health and disability insurance to provide coverage for infertility treatment. Treatment must include at least four complete cycles of any one or a combination of any non-experimental reproductive assistance technologies.

The Connecticut Senate Committee on Insurance introduced S.B. 547 on February 29, 2000. This measure would require certain health insurers to provide coverage of specified types of infertility treatment services. S.B. 547 was assigned to the Joint Committee on Insurance and Real Estate on its date of introduction.

Two measures are currently pending in Florida that address infertility coverage. H.B. 31, sponsored by Representative Wasserman, was assigned to the House Interim Committee on Health Care Services on February 23, 2000. This bill would require a specified list of insurance carriers to provide coverage for the diagnosis and treatment of infertility. Certain types of procedures would be excluded from the mandated coverage requirement, and certain religious organizations would not be required to purchase plans that include that particular mandated benefit.

Also in Florida, Senator Geller introduced identical legislation on February 24, 2000 known as S.B. 1478. This measure was assigned to the Senate Interim Committees on Banking and Insurance, Health, Aging and Long-Term Care and Fiscal Policy.

Senator Martin, of New Jersey, has sponsored S.B. 1076. This legislation, which was assigned to the Senate Committee on Health on February 28, 2000, would require certain health insurers to provide enrollees with coverage of the diagnosis and treatment of infertility.

In Oklahoma, Representative Davis’ bill, H.B. 1338, passed the House Judiciary Committee with an amendment on February 24, 2000. This bill would require certain health insurance carriers to provide coverage for the diagnosis of infertility, as well as for specific infertility treatments.

Virginia H.B. 1151, sponsored by Delegate Barlow, was carried over to the 2001 legislative session on February 12, 2000. This bill would require certain health insurance carriers to provide enrollees with coverage for the treatment of infertility.

Other Mandates: In addition to the bills identified herein that address clinical trials, cancer screening and treatment, prescription drugs and infertility, state lawmakers have been considering mandate bills that address coverage of a wide variety of other health services. Some of the mandate bills that have been acted upon recently include the following:

In Florida, Senator Dawson prefiled S.B. 1836, which is very similar to H.B. 523 and S.B. 1836. This bill would require certain health insurance policies and HMO contracts to include coverage of one routine eye examination for certain enrolled children. This measure was assigned to the Senate Interim Committees on Banking and Insurance and Fiscal Policy on March 6, 2000.

Senator Chun-Oakland, of Hawaii, sponsored S.B. 2657 on January 26, 2000. This bill, which would require specified types of health insurance plans to include coverage of diabetes self-management training and education, as well as diabetes equipment and medical supplies, passed the Senate Committee on Health and Human services with an amendment on February 9, 2000.

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. A fiscal note was filed for this measure on February 29, 2000.

In Indiana, legislation introduced by Senator Wheeler concerning mandating insurance coverage for morbid obesity passed the House Committee on Ways and Means as amended on February 17, 2000.

Two mandate bills recently were acted upon in Iowa. H.F. 754, which was introduced by the Committee on Insurance during the 1999 session, passed the House Committee on Commerce and Regulation on February 21, 2000. This legislation would require specified types of private health insurance to include coverage of anesthesia and certain hospital expenses associated with the coverage of dental care services. Senator McCoy introduced identical legislation on January 20, 2000. This measure was reclassified as S.F. 2408 on February 29, 2000.

Delegate Barve, of Maryland, introduced S.B. 1125 on February 11, 2000. This legislation would require certain insurers to provide enrollees with coverage of certain types of treatment and assistance associated with participation in a smoking cessation program. This bill was assigned to the House Committee on Economic Matters upon introduction.

In New York, Assembly Member Klein introduced A.B. 9679, which is identical to S.B. 6097, sponsored by Senator Hannon. This bill would require certain HMOs and managed care organizations to provide enrollees with coverage for end-of-life care and adult care services. This measure was assigned to the Assembly Committee on Health on March 1, 2000.

In Virginia, four mandate bills are awaiting the Governor’s signature. H.B. 574, sponsored by Delegate Bryant, would exempt certain short-term heath insurance policies from the state mandate that health insurers offer coverage for child health supervision services. Also by Delegate Bryant, H.B. 914 would require specified types of health insurance carriers to provide coverage for all routine immunizations for children up to 3 years of age.

Delegate Armstrong of Virginia introduced H.B. 1376. 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.

Finally, Senator Edwards sponsored legislation that would require certain health insurance carriers to provide enrollees with coverage for all routine childhood immunizations. S.B. 221 was sent to the Governor on February 29, 2000.

Medical Savings Accounts

On February 29, 2000 in Colorado, the Senate passed H.B. 1037, which was sponsored by Representative Hoppe. This bill would create a catastrophic health plan that must be purchased by an individual who has a medical savings account. The health plan would have a deductible of at least $1500 but no more than $2200 for individuals and at least $3000 but no more than $4500 for families.

In Hawaii, the House Committee on Legislative Management passed H.B. 2361, which was sponsored by Representative Pendleton, on February 7, 2000. This bill would establish a pilot program for state legislators and legislative employees and their dependents to establish MSAs. A contribution range of $1,500 to $2,500 for individuals and $3,000 to $4,500 for families would be established. The measure also specifies that the tax-free account was designed only for the purchase of a health insurance plan or to pay for medical expenses.

Mental Health and Substance Abuse Parity

Parity legislation was addressed recently in eight states—Florida, Hawaii, Kansas, Massachusetts, New Hampshire, New Mexico, New York and Utah. In Florida, legislation was introduced by Senator Myers that would require certain group health insurers to offer coverage for mental health conditions other than serious mental illnesses. S.B. 1658 was assigned to the Senate Interim Committees on Banking and Insurance and Fiscal Policy.

Hawaii Senator Chun-Oakland introduced S.B. 2974 on January 26, 2000. This measure was read in the Senate for the second time on March 3, 2000 and would require certain insurance carriers to provide coverage for substance abuse treatment services.

Kansas S.B. 547 is currently pending before the Senate Committee on Financial Institutions and Insurance. This bill, which was sponsored by the members of that committee, would require certain types of health insurance to include coverage for specified types of mental health conditions.

In Massachusetts, legislation was introduced last session by Senator Bernstein that would provide all individuals covered by the state group insurance commission for public employees with coverage for or certain biologically based mental illnesses. S.B. 2036 was sent to conference on February 17, 2000, and the House conferees were appointed on February 28, 2000.

Legislation was sponsored by Representative Crosby in New Hampshire that would establish a committee to study the treatment of mental health conditions under managed care plans in the state. H.B. 1134 passed the House on February 17, 2000 and was assigned to the Senate Committee on Insurance.

Mental health parity legislation passed the New Mexico legislature on February 12, 2000, and is awaiting the Governor’s signature. Representative Sandoval sponsored H.B. 432 and it would require specified health insurance carriers to provide equal coverage for the treatment of mental health conditions.

New York A.B. 286, which was introduced by Assembly Member John during the 1999 legislative session, would prohibit certain limitations on insurance coverage for the treatment of alcohol or substance abuse addictions. This measure passed the Assembly on February 28, 2000 and was sent to the Senate Committee on Alcoholism and Drug Abuse.

Two parity measures were proposed in Utah. H.B. 35, sponsored by Representative Buffmire, would require certain health insurers to provide equal coverage for mental health conditions, including cost-sharing and payment limits, as provided for other physical health conditions. This measure passed the Senate on March 1, 2000, and the House has concurred with the Senate’s amendments.

Also in Utah, Representative Holladay proposed H.B. 123, but it was defeated on the House floor on February 22, 2000. This bill would have also required parity in mental health coverage, but it would have phased in the requirement over three years and provided certain exemptions for managed care plans.

Ombudsman

On February 4, 2000 in Washington, S.B. 6830 sponsored by Senator Franklin was referred to the Senate Committee on Human Services and Corrections. This act would create an independent office of mental health ombudsman. The office would help to comply with the community mental health services act and the Medicaid managed care mental health waiver.

Single-Payer Health Plans

In New York, legislation was introduced on February 18, 2000 by Senator Stavisky that would create a single-payer health plan in the state funded by a premium tax on employers. S.B. 6633 is currently pending before the Senate Committee on Health.

The Uninsured

Action was taken on legislation in Arizona sponsored by Representative Knaperak that would establish the Premium Sharing Program in the state to help subsidize health insurance coverage for uninsured state residents. H.B. 2262 would fund the program through revenues from the state’s share of the master tobacco settlement of 1998. This measure was pending before the House Committee of the whole as of February 24, 2000.