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State Legislative Update

March 13- March 17, 2000

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

Antitrust

Action was taken on antitrust legislation in Florida, New Jersey and Tennessee. In Florida, Representative Lawson sponsored H.B. 1589 on March 7, 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. The measure was assigned to the House Committees on the Judiciary, Health Care Services, Insurance, General Appropriations, Governmental Rules and Regulations, and Finance and Taxation on March 10, 2000.

A.B. 2169, sponsored by Assembly Member Chatzidakis in New Jersey, would allow physicians to collectively bargain with health benefit plans over certain contract provisions. This legislation was introduced on March 2, 2000 and assigned to the Assembly Committee on Health that same day.

Representative Curtiss’ bill in Tennessee, H.B. 2936 passed the House Committee on Health and Human Resources’ Subcommittee on Public and Consumer Health on March 7, 2000. This bill, which is known as the Health Care Provider Joint Negotiations Act, would allow physicians to enter into joint negotiations with health plans concerning certain contractual provisions.

Confidentiality

Senator Hollinger sponsored S.B. 371 in Maryland. On March 13, 2000 it passed the Senate, and the next day it was referred to the House Committee on Environmental Matters. 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.

In Michigan, H.R. 292 was introduced by Representative Barter and then referred to the House Committee on Constitutional Law and Ethics on March 2, 2000. This measure would memorialize the United States Congress and President to enact federal legislation to protect the privacy of medical records.

On March 11, 2000 in South Dakota, the Governor signed into law, H.B. 1175 sponsored by Representative Hunt. 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.

H.B. 603 became eligible for the Governor’s desk on March 6, 2000 in Virginia. 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.

Genetic Discrimination

The Idaho Senate Committee on State Affairs introduced a bill, H.B. 1567, on March 13, 2000 that would prohibit specified health insurers, as well as employers, from discriminating against individuals on the basis of genetic testing.

Health Insurance Tax Incentives

In Idaho, S.J.M. 108 passed the Senate and was then referred to the House Committee on Business on March 10, 2000. The Senate Committee on State Affairs sponsored this measure that would memorialize the United States Congress and the President to enact federal legislation to provide a full deductibility from federal income tax for individuals who purchase individual and small groups health insurance.

The House Committee on Taxation and Revenue introduced H.B. 707 in Idaho and on March 10, 2000 it passed the House, and was referred to the Senate Committee on Local Government and Taxation. 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.

In Missouri, Representative Wiggins introduced H.B. 1643 and on February 3, 2000 it was referred to the House Committee on Ways and Means. This measure would amend existing state laws on income taxation. A resident of the state would be able to deduct from his/her state taxable income 100 percent of health insurance premiums paid by the individual that are not otherwise deductible.

Health Plan Liability

In Alaska, H.B. 211 sponsored by Representative Rokeberg passed the House Committee on Labor and Commerce and then was referred to the House Committee on Judiciary on March 8, 2000. This measure would provide a civil liability of managed care entities that do not exercise ordinary care when making treatment decisions. Health plan contracts would need to clearly identify all health care services that the plan provides and covers. Also a utilization review and external review process must clearly be identified and explained by the health plan.

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 House Committee on Banking and Insurance on March 7, 2000.

Four similar bills relating to health plan liability have had recent legislative activity in Florida. Senator Geller sponsored S.B. 788, to be known as the “Managed Care Organization Accountability Act of 2000.” This act has been referred to the Senate Committee on Banking and Insurance on March 14, 2000. This legislation would establish that specified health insurance carriers, HMOs, and managed care entities have the duty to exercise ordinary care when making health treatment decisions, and are liable for any harm or damages to an insured individual caused by the failure to exercise ordinary care. Furthermore, carriers, HMOs, and other managed care organizations would be liable for damages for harm caused by the failure of their employees, agents, or other representatives to exercise ordinary care when making health treatment decisions.

The other similar bills to S.B. 788 in Florida are S.B. 424, H.B. 291 and S.B. 282. S.B. 424 was introduced by Senator Campbell on March 7, 2000 and has been referred to the Senate Committee on Banking and Insurance. Representative Sobel introduced H.B. 291 on March 7, 2000. Senator Silver sponsored the third bill S.B. 282 and on March 14, 2000 it was sent to the Senate Committee on Banking and Insurance.

In Maryland, H.B. 943, sponsored by Representative Zirkin, was withdrawn from further consideration on March 14, 2000. This act would have established 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 have been exercised when making health care treatment decisions for the insured.

On January 12, 2000 in West Virginia, Senator Kessler introduced S.B. 27. This measure was then referred to the Senate Committee on Banking and Insurance. S.B. 27 would add to an existing state code relating to health plan carriers and HMOs. A carrier and HMO has the duty to exercise ordinary care and would be held liable for any damage to enrollees caused by a failure to do so. For a civil suit to be filed against the carrier or HMO, the enrollee must have exhausted all appeals and reviews. A written notice of the civil claim must be filed with the carrier or HMO. The claim must then be sent to an independent review organization for authorization to proceed, unless the harm or damages have already occurred.

Health Purchasing Cooperatives

In Florida, Senator King sponsored S.B. 2086 and on March 13, 2000 it was referred to both the Senate Committee on Banking and Insurance and the Senate Committee on Health, Aging and Long-Term Care. This measure would insure small employers under health insurance policies that are issued to small employer health alliances that are organized as not-for-profit organizations. It also authorizes health insurance carriers to issue group health insurance policies to small employer health alliances.

Representative Farkas in Florida sponsored H.B. 1571, which is a similar measure to S.B. 2086. H.B. 1571 was referred to the House Committee on Health Care Services, the House Committee on Insurance, and the House Committee on Health and Human Services Appropriations on March 10, 2000.

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 Commerce on March 6, 2000. S.F. 3161, sponsored by Senator Kiscaden, passed the Senate Committee on Health and Family Security on March 6, 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

The Idaho House Committee on Ways and Means introduced H.B. 750 on March 13, 2000. This bill would create a high-risk reinsurance pool in the state for individual health insurance carriers. H.B. 750 would establish funding for the pool through premium tax revenues.

In Mississippi, all three risk-pool bills being considered by the Legislature died in committee on March 7, 2000. H.B. 915, sponsored by Representative Evans, would have revised the eligibility requirements for coverage in the state’s pool. Senator Kirby’s bill, S.B. 2999, would have prohibited an assessment on insurance carriers from being used as the funding mechanism for the state’s high-risk pool. Finally, Mississippi S.B. 3094 would have established 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 have also increased the maximum benefit limit for pool participants. Senator Burton sponsored S.B. 3094.

Long-Term Care

Lawmakers in Missouri and Nebraska addressed long-term care legislation. In Missouri, Representative Kissell introduced H.B. 2076 on February 28, 2000, and the measure was assigned to the House Ways and Means Committee on March 7, 2000. This measure would amend existing law to allow state residents to deduct 100 percent of all non-reimbursed amounts paid for qualified long-term care insurance premiums to the extent that such amounts are not included in the individual’s itemized deductions.

Two bills, L.B. 943 and L.B. 955, were postponed indefinitely by the Nebraska Legislature on March 13, 2000. L.B. 943, which was sponsored by Representative Wickersham, would have allowed an individual to deduct the amount paid for long-term care insurance premiums during the taxable year for the taxpayer, the taxpayer’s spouse, parent, immediate family member or other dependent, for the purposes of calculating state income tax liability.

L.B. 955 would have amended a portion of the state’s existing code to allows for a state income tax credit for individuals that purchase long-term care insurance for themselves, their spouse, a parent, an immediate family member or other dependent. Representative Jensen sponsored L.B. 955.

Managed Care Reform/Patient Protection

In Alabama, H.B. 508 was introduced and referred to the House Committee on Health on February 17, 2000. Representative Millican sponsored this bill that would change an existing Alabama law that states a health insurance contract must only cover an assisting physician, not a registered nurse first assistant in surgeries. This bill would allow a registered nurse first assistant to be reimbursed for services under a health insurance contract to improve the quality of patient care and lower medical costs.

In Colorado, Senator Wattenberg sponsored S.B. 95, which on March 13, 2000 passed the House and was then sent back to the Senate for concurrence. 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, and it was reported out of the Legislative Commissioner’s Office then reissued to the Legislative Commissioner’s Office with file number 53 on March 13, 2000. This bill would prohibit financial incentives from a managed care organization to a health care provider based on that provider’s treatment decisions.

Also in Connecticut, the Senate Committee on Insurance sponsored S.B. 48 and on March 9, 2000 it was filed with the Legislative Commissioner’s Office. This measure would require that managed care organizations not penalize a health care provider that specifies that there be no substitutions for a specific brand name prescription drug that the provider prescribes to their patient.

Eight bills relating to managed care reform or patient protection had recent legislative activity in Florida. Senator Laurent introduced S.B. 706 on March 14, 2000 and it was then referred to the Senate Committee on Baking and Insurance. This measure would define a “clean claim,” as a completed claim filled out on the correct form and submitted by an enrollee’s physician for medical care or health care services that are provided under a health plan. This measure also specifies procedures that the health plan must follow in order to contest a claim.

S.B. 866, sponsored by Senator King, was referred to the Senate Committee on Baking and Insurance on March 14, 2000. This measure states that an HMO contract could not prohibit or restrict a physician’s ability to provide hospital services to enrollees of a health plan. The HMO would not be able to deny payment to the provider for hospital services when they are medically necessary.

Representative Villalobos introduced H.B. 149, which is similar to S.B. 866, on March 8, 2000.

The fourth bill in Florida relating to managed care reform is S.B. 1534. This bill was sponsored by Senator Geller and referred to the Senate Committee on Banking and Insurance on March 14, 2000. This bill would modify the grievance procedure for managed care organizations. A health plan subscriber would be held accountable for costs and attorney fees for court proceedings that the subscriber had filed that were deemed improper.

Senator Geller also sponsored S.B. 2058, which would not allow health insurance carriers and HMOs to be deceptive and unfair towards health care providers. A deceptive practice would be to require a provider as a condition of participation in the health plan to participate in the carrier’s affiliate plans that have different terms, conditions, or level of payments then the one the provider is applying for.

Also in Florida, S.B. 1580 was referred to the Senate Committee on Banking and Insurance. This measure is sponsored by Senator Campbell and would provide a grievance process for health plan subscribers. Grievances brought by health plan subscribers against an HMO would be required to go through a formal internal appeal process. If the subscriber is unhappy with the internal appeal decision, then an external appeal can be sought. The state Health Care Administration would oversee the appeals process to determine if it is followed correctly.

Senator Brown-Waite sponsored S.B. 1900 that was sent to the Senate Committee on Banking and Insurance on March 14, 2000. This measure creates the Managed Care Organization’s Patient Bill of Rights to provide quality health care and benefits to all resident of Florida. Health plan enrollees should be provided a copy of their rights and the opportunity to file a civil suit against a health plan that does not exercise ordinary care when making treatment decisions. Damages against a health care plan can be sought in the amount of $500 or the actual cost of damages.

The last bill in Florida, S.B. 2234, sponsored by Senator Saunders, was referred on March 13, 2000 to the Senate Committee on Aging and Long-Term Care. This measure would not allow an HMO to deny payment to a health care provider for covered services unless certain conditions are meet.

In Hawaii, H.B. 2811 was introduced by Representative Santiago and then referred to the House Committee on Finance on February 18, 2000. This measure would require a managed care plan to provide a procedure for the resolution of an enrollee’s complaints and appeal of treatment decisions. It also includes a requirement for an expedited appeal process for those enrollees whose life depends on the treatment that is in question.

Also in Hawaii, Senator Chun-Oakland introduced S.B. 2655 on January 26, 2000. This measure would change the appeal process for a health plan treatment decision. Enrollees would be able to request an expedited appeal from the health plan. An expedited appeal may occur within a seventy-two hour review period when the enrollee’s life is in serious jeopardy or when the enrollee has severe pain that can not be treated without the care that is the subject of the appeal.

Representative Johns in Kentucky sponsored H.B. 390, which was reported favorably with a substitute from the House Committee on Appropriations and Revenue on March 9, 2000. This measure would provide for an external review procedure. The State Insurance Commissioner shall report every six months to the Interim Joint Committee on Banking and Insurance and to the Governor, the number of external reviews that are requested as well as a summary of the findings and recommendations of the external review entity.

In Maryland, H.B. 669 sponsored by Representative Goldwater was adopted on the House floor on March 14, 2000. This bill would amend an 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.

On March 10, 2000, also in Maryland, S.B. 359 sponsored by Senator Exum passed the Senate and was then referred to the House Committee on Environmental Matters. This measure would require an HMO to establish a mechanism that would limit the number of enrollees assigned to each provider to create a balance in the amount of patients each provider receives from the HMO.

S.F. 3156 passed the Senate Committee on Health and Family Security and was re-referred to the Senate Committee on Commerce on March 1, 2000 in Minnesota. Senator Berglin sponsored this act, which provides patient protection measures and also 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 New Hampshire, H.B. 1481 failed to pass the House on March 9, 2000. This bill would have required a managed care organization to offer a prescription drug plan to all enrollees of the health plan. Representative Lynott sponsored this bill.

On March 6, 2000 in Oklahoma, S.B. 1588 passed the Senate and on March 8, 2000 it was referred to the House Committee on Public Health. This measure is sponsored by Senator Monson and relates to the Oklahoma Managed Care Act by modifying definitions of terms.

Senator Kelly in Rhode Island introduced S.B. 2696 on February 10, 2000. This bill was then referred to the Senate Committee on Corporations where it was recommended for passage on March 8, 2000. 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.

Another bill in Rhode Island, S.B. 2303 sponsored by Senator Gibbs was also recommended for passage as amended in the Senate Committee on Corporations on March 8, 2000. This measure would require an HMO to provide temporary credentials to a health care provider while the HMO reviews the provider’s application to participate in the HMO’s network.

In Utah, S.B. 95 sponsored by Senator Knudsen, passed both the House and Senate, and on March 7, 2000 was signed by the Governor. This act will 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.

H.B. 660 sponsored by Representative Grayson in Virginia became eligible for the Governor’s desk to be signed into law on March 8, 2000. If a health plan covers emergency services then they would be required to reimburse any physician that provides those emergency health care services without obtaining prior authorization. Emergency services can be obtained when there is a sudden onset of a medical condition with severe symptoms or pain that with the absence of medical attention could, by the standards of a layperson, result in serious jeopardy to the mental or physical health of the individual or a woman’s unborn child.

In Washington, H.B. 2031 sponsored by Representative Ruderman passed the House on February 9, 2000, and then passed the Senate on February 29, 2000. This measure would amend the definition of a health care practitioner to include a midwife. A woman may choose to see a mid-wife for obstetrical care directly without obtaining a referral from a primary care provider.

Also in Washington, similar bills H.B. 2331 sponsored by Representative Campbell and S.B. 6199 sponsored by Senator Wojahn, have been referred to the House Committee on Rules and have passed the House and sent to the Senate for concurrence respectively. Both measures were created to ensure that patients who are covered by health plans receive quality health care. These acts 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; (4) and ensure the privacy of the individuals medical information.

Senator Hunter introduced S.B. 70 in West Virginia on January 14, 2000. The measure have has passed the House Committee on Government Organization and been sent of the House Committee on Finance on March 3, 2000. This measure would amend the West Virginia Patient’s Bill of Rights Act by requiring all managed care plans to provide to enrollees on a yearly basis information about the managed care health plan. Included in the information should be: (1) a description of the enrollee’s rights and responsibilities; (2) the plan’s benefits and limitations; (3) premium costs; (4) cost sharing requirements; (5) complaint procedures; (6) and a provider network.

Also in West Virginia, Representative Campbell introduced H.B. 2124 on January 12, 2000. This measure relates to HMOs, to amend the definition of a primary care provider. A nurse practitioner would be included in the definition as a primary care provider. A nurse-midwife would also be considered a primary care physician for a woman during her pregnancy and up to 60 days after the pregnancy.

Mandated Benefits

Clinical Trial Mandates: Legislation concerning coverage of participation in clinical trials was considered in Connecticut, Florida and Minnesota. 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 the costs of any procedure or treatments associated with the participation in a clinical trial for the treatment of cancer, which are 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 failed to meet the joint favorable deadline on March 9, 2000.

Senator Lee of Florida sponsored 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 the carriers to provide such enrollees with coverage and reimbursement of costs. S.B. 1178 was formally introduced on March 7, 2000.

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 Commerce Committee on March 6, 2000. The House Committee on Health and Human Services Policy approved identical legislation known as H.F. 3610, which was sponsored by Representative Goodno on March 8, 2000. This bill was then assigned to the House Commerce Committee.

Drug-related Mandates: Lawmakers in five states—California, Florida, Maryland, New York and Utah—addressed legislation that would mandate coverage of specific types of prescription drugs. In California, Senator Spier introduced S.B. 2046 on February 25, 2000. This bill would amend the state’s existing law concerning insurance coverage of off-label prescription drugs by specifying that insurers must also cover off-label drugs prescribed for the treatment of a chronic or disabling condition. This measure was assigned to the Senate Insurance Committee on March 9, 2000.

In Florida, H.B. 1469, sponsored by Representative Edwards, would prohibit certain health insurance carriers and HMOs from excluding coverage for certain types of non-approved prescription drugs prescribed for the treatment of chronic, disabling or life-threatening conditions. This legislation was formally introduced on March 7, 2000.

Senator King introduced a similar bill, known as S.B. 2008, on March 7, 2000. This bill was assigned to the Senate Committees on Banking and Insurance, Fiscal Policy, and Health, Aging and Long-Term Care on March 9, 2000.

Maryland H.B. 896, which was sponsored by Delegate Elliott, was withdrawn from further consideration on March 7, 2000. This bill would have required specified health insurers and managed care organizations to provide equitable coverage for mail-order prescription drugs and non-mail order prescription drugs.

Senator Schneiderman introduced legislation on March 2, 2000 in New York that would require certain health and accident insurance policies to cover the cost of prescription contraceptives. S.B. 6773 was assigned to the Senate Committee on Insurance on March 2, 2000.

In Utah, the enacting clause of S.B. 9, sponsored by Senator Johnson, was stricken on March 2, 2000. This bill would have required certain health insurance policies to provide coverage for all FDA-approved prescription contraceptives and related outpatient services.

Infertility Mandates: Three states—Connecticut, Florida, and Mississippi—took action on legislation mandating coverage for the diagnosis and/or treatment of infertility. 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 failed to meet the joint favorable deadline on March 9, 2000.

Two measures in Florida addressing infertility coverage were officially introduced on March 7, 2000. 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. Senator Geller introduced identical legislation known as S.B. 1478.

In Mississippi, Representative McCoy introduced legislation that would require certain insurance policies to provide benefits for infertility treatment services. This measure was defeated in the House Insurance Committee on March 7, 2000.

Other Mandates: In addition to the bills identified herein that address clinical trials, 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, six pre-filed mandate bills were formally introduced on March 7, 2000. H.B. 93, sponsored by Representative Crow, and its companion bill, S.B. 164, introduced by Senator Scott, would require certain health insurance carriers and HMOs to provide coverage for the diagnosis and treatment of autism spectrum disorder.

Representative Posey introduced H.B. 673, and Senator Clary introduced a similar measure known as S.B. 996. Both of these bills would require certain insurers and HMOs to pay for enrollee’s clinical laboratory services under specified conditions.

Also in Florida, Representative Greene introduced legislation that would require medical insurers and managed care organizations to reimburse patients who choose to receive natural hormone replacement therapy. Similar legislation was sponsored by Senator Dawson, and S.B. 1882 was assigned to the Senate Committees on Banking and Insurance, Fiscal Policy and Health, Aging and Long-Term Care on March 9, 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 Senate on March 7, 2000 and was assigned to the House Committee on Consumer Protection and Commerce on March 10, 2000. Identical legislation sponsored by Representative Kawakami, known as H.B. 2392, passed the House on March 9, 2000 and was referred to the Senate Committee on Health and Human Services.

Indiana H.B. 1293, sponsored by Representative Ruppel, was sent to the Governor for signature on March 9, 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.

Also in Indiana, legislation introduced by Senator Wheeler concerning mandating insurance coverage for morbid obesity was sent to the Governor’s desk on March 10, 2000. S.B. 212 would apply to specified HMOs and insurers that issue accident and sickness policies.

Maryland S.B. 496 passed the Senate on March 9, 2000 and was referred to the House Committee on Economic Matters the next day. This legislation would require certain health insurance carriers, non-profit health plans and HMOs to provide coverage for expenses associated with the surgical treatment of morbid obesity under specified circumstances.

Senator VanHollen, of Maryland, introduced S.B. 518 on February 4, 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. The Senate passed this bill on March 10, 2000.

Medical Savings Accounts

On March 10, 2000 in Colorado, H.B. 1037, which was sponsored by Representative Hoppe, was sent to the Governor to be signed into law. 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. Mental Health and Substance Abuse Parity Parity legislation was addressed recently in five states—Florida,

Hawaii, Missouri, Rhode Island and Utah. In Florida, legislation sponsored by Senator Myers 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 on March 6, 3000 and formally introduced the next day. Hawaii Senator Chun-Oakland introduced S.B. 2974 on January 26, 2000. This measure passed the Senate on March 7, 2000 and assigned to the House Committee on Health on March 9, 2000. This bill would require certain insurance carriers to provide coverage for substance abuse treatment services.

In Missouri, Representative Schilling introduced H.B. 2115 concerning coverage of mental illnesses and substance abuse treatment. This legislation would require certain specified individual and group insurers and managed care entities that provide coverage for mental illnesses and chemical dependency services to use the same cost-sharing and benefit limitation mechanisms for inpatient and outpatient mental health and chemical dependency services as are used for other inpatient and outpatient medical treatment services.

Rhode Island H.B. 8013 was sponsored by Representative Kilmartin on March 8, 2000 and immediately assigned to the Joint Committee on Highways and Safety and the House Finance Committee. This legislation would amend existing law to require certain insurers to provide complete coverage for enrollee treatment in residential adolescent substance abuse programs approved by the state.

H.B. 35, sponsored by Representative Buffmire of Utah, 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 was sent to the Governor for signature on March 8, 2000.

Ombudsman

In Florida, Senator Saunders introduced S.B. 336 on March 7, 2000, then on March 14, 2000 it was referred to the Senate Committee on Banking and Insurance. This measure creates a statewide-managed care ombudsman office that will be within the Agency for Health Care Administration. The ombudsman office will assist consumers in resolving complaints against managed care plans. The office will be part of a two-year pilot program that will be funded by an assessment on health care premiums.

S.B. 479 in Georgia was sponsored by Senator Madden and then referred on March 1, 2000 to the Senate Committee on Insurance and Labor. A position for a state mental health, mental retardation and substance abuse ombudsman is created by this measure. The position would be for a full-time employee that would work for the consumers’ insurance advocate in the Governor’s office. The ombudsman will advocate the right of those with disabilities and promote a well being and quality of lives. One duty of the ombudsman will be to set a program up to investigate, report and resolve complaints against insurance carriers by those with mental health conditions, mental retardation or substance abuse.

Single-Payer Health Plans

Florida S.B. 402, sponsored by Senator Latvala, was introduced on March 7, 2000. This bill would establish the Florida Health Endowment Association to administer a comprehensive health insurance plan for state residents. S.B. 402 outlines an administrative framework for the insurance plan, establishes eligibility requirements, mandates covered benefits, and provides for premiums and deductibles. The measure also appropriates funds for the development of the health insurance plan. A similar bill, H.B. 645, sponsored by Representative Green, was introduced on that same date.

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 passed the Senate Finance Committee as amended on March 9, 2000.

In Connecticut, Senator Harp proposed legislation on February 10, 2000 that failed to meet the joint favorable deadline on March 9, 2000. S.B. 107 would have allowed certain self-employed state residents who met specified financial considerations purchase health insurance under the state HUSKY plan or the state insurance program for public employees.