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State Legislative Update

May 8 - May 19, 2000

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

Antitrust

Representative Trakas, of Ohio, introduced H.C.R. 65 on May 2, 2000. This measure requests that the U.S. Congress enact H.R. 1304, which would establish a federal antitrust waiver for physicians. On May 9, 2000 the House Committee on Commerce and Labor held a hearing on this bill.

In Tennessee, S.B. 2672, which was known as the Healthcare Provider Joint Negotiations Act, was indefinitely postponed on May 9, 2000. This legislation would have allowed collective bargaining by physicians with health benefit plans under specified circumstances. Senator Cohen was this measure’s sponsor.

Children’s Health Insurance Program

Action was taken in five states—Alabama, California, Colorado, Mississippi, and New York. In Alabama, H.J.R. 100 was introduced to the House Committee on Rules on February 15, 2000. On May 9, 2000 the bill was sent to the Senate Committee on Rules. This bill would reestablish the Children’s Health Insurance Program Commission in the state and outlines the composition and duration of the Commission.

In California, A.B. 1015 was introduced on February 25, 2000. On May 8, 2000 the bill was referred to the Senate, read for a second time and amended. It was then re-referred to the Senate Committee on Insurance. This measure would provide for administration of the state Children’s Health Insurance Program by both the state Department of Health Services and the state Managed Risk Medical Insurance Board. Administration would include the development of safeguards to assure the fiscal integrity of the program, participation standards, program review, administrative hearings and appeals, appointment of members to the 15 member advisory board and the preparation of annual reports.

In Colorado, S.B. 223 was introduced on April 12, 2000, and on May 18, 2000 the bill was sent to the Governor. This bill makes changes to the non-Medicaid state-subsidized insurance program known as the "Children’s Basic Health Plan."

In Mississippi, H.B. 1469 was introduced to the House Committee on Public Health and Welfare on February 21, 2000. On May 8, 2000 it became eligible for the Governor’s desk. The bill revises eligibility criteria under CHIP to provide that a person who is without insurance coverage at the time of application for the program, and who meets other eligibility criteria, will be eligible to receive covered benefits under the program subject to federal approval.

In New York, A.B. 10346 was introduced on March 28, 2000, and on May 9, 2000 the bill was assigned to the Assembly Committee on Ways and Means. This measure would direct the Department of Health to contract with community-based organizations and not-for-profit corporations for the provision of outreach, information and educational services to immigrants, including information on the availability of healthcare services, medical assistance and the Children’s Health Insurance Program in the state.

Also in New York, S.B. 7523 was introduced on April 17, 2000 to the Senate Committee on Health. On May 10, 2000 the bill passed the Committee. This legislation would include within the coverage provided under the state Children’s Health Insurance Program, pre-hospital emergency medical services for the treatment of emergency medical conditions when such services are provided by an ambulance service.

Confidentiality

In two states, Maryland and Rhode Island, action was taken on confidentiality legislation. Senator Hollinger sponsored S.B. 371 in Maryland. On May 11, 2000 the Governor signed the bill into law. This measure establishes that any person may be held liable for punitive damages if he/she knowingly obtains 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 is also established to conduct hearings, monitor federal laws, and make recommendations to the General Assembly regarding privacy and confidentiality of medical records.

S.B. 2547, in Rhode Island, passed the Senate and was assigned to the House Committee on Judiciary on May 16, 2000. Senator Cicilline sponsored this resolution, which would create a special joint commission to study the definition, handling and release of confidential health information. The commission would report their findings and recommendations to the General Assembly by no later than June 8, 2001.

Genetic Discrimination

Action was taken on two genetics bills in New York. The Assembly Rules Committee amended A.B. 3435 on May 10, 2000. This bill, which was sponsored by Assembly Member Morelle, would prohibit life and disability carriers from denying or canceling coverage based on the genetic information of an enrollee or an enrollee’s family member. Carriers would also be prohibiting from requesting genetic information from an enrollee or an enrollee’s family member.

The New York Assembly’s Rules Committee also considered Assembly Member Sweeney’s bill on May 10, 2000. A.B. 7186 would prohibit group health insurers from discriminating against prospective enrollees based on any predisposing genetic characteristics the enrollee may have.

Health Plan Liability

In Florida, two similar bills, H.B. 291 and S.B. 788, died in the Senate on May 5, 2000. Both bills would have established that specified health insurance carriers, health maintenance organizations (HMOs) and managed care entities have the duty to exercise ordinary care when making health treatment decisions, and that they 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 have been 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.

Health Purchasing Cooperatives

Representative Farkas sponsored H.B. 1571 in Florida, and on May 5, 2000 it died on the House calendar. This measure would have insured small employers under health insurance policies, which would have been issued to small employer health alliances that were organized as not-for-profit organizations. H.B. 1571 would have also authorized health insurance carriers to issue group health insurance policies to small employer health alliances.

Long-Term Care

Action was taken on long-term care legislation in Alabama and California. In Alabama, the Senate Health Committee passed H.B. 170 as amended. This legislation, which was sponsored by Representative Newton, is known as the Long-Term Care Insurance Policy Minimum Standards Act. It would establish that long-term care insurance policies are to be regulated by the state Commissioner of Insurance.

California A.B. 2281, a 100 percent long-term care tax deduction bill, passed the Assembly Committee on Revenue and Taxation on May 4, 2000 with an amendment. This bill, which was originally introduced by Assembly Member Alquist, was then read for a second time on the Assembly floor and returned to the Committee on Revenue and Taxation. A.B. 2281 covers long-term care insurance purchased by a taxpayer for either the taxpayer, his/her spouse and/or any dependents.

Managed Care Reform/ Patient Protection

Lawmakers in Alaska, Florida, Maryland, Michigan, New Hampshire, Oklahoma and Rhode Island took action on legislation related to managed care reform or patient protection. On May 5, 2000 in Alaska, H.B. 121, which Representative Bunde sponsored, was sent to the Governor to be signed into law. This bill relates to a patient’s right to dental care. A health plan would not be able to restrict in any way a patient’s access to a dentist when the plan contract covers dental care. The enrollee would be able to bring civil action against the health insurer if his/her right to a dentist was impeded.

Two similar bills in Florida, H.B. 1523, sponsored by Representative Sublette, and S.B. 2058, sponsored by Senator Geller, died in committee on May 5, 2000. Both measures would have prohibited health insurance carriers and HMOs from being deceptive and unfair towards healthcare providers. A deceptive practice would have been to require a provider, as a condition of participation in the health plan, to participate in the carrier’s affiliate plans that had different terms, conditions or level of payments then the one for which the provider was applying.

The Governor in Maryland signed three bills into law on May 11, 2000. H.B. 669, sponsored by Delegate Goldwater, amends an existing state law to allow women greater access to obstetrical or gynecological care. HMOs will have to 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.

H.B 1016, the second bill signed in Maryland, was sponsored by Delegate Hurson. Certain insurers and HMOs are now prohibited from making payments for the treatment of specific diseases or ailments subject to different copayments, deductibles or maximum limits then any other disease or ailment covered by the health plan.

Lastly in Maryland, S.B. 405, which was sponsored by Senator Astle, establishes a provider payment procedure for health plans. A healthcare provider must be paid by the health plan within 30 days of filing a clean claim for services rendered.

H.B. 5787, in Michigan, was introduced and referred to the House Committee on Insurance and Financial Services on May 16, 2000. This measure, sponsored by Representative Schauer, would prohibit HMOs from providing financial incentives or penalties to healthcare providers that directly or indirectly limit healthcare services to patients. This measure would not prohibit the use of bonuses or other financial arrangements made by HMOs, which are to be awarded to providers on the basis of quality of care.

In Michigan, two bills, S.B. 1210 sponsored by Senator Shugars and S.B. 1208 sponsored by Senator Schwartz, were heard in the Senate Committee on Health Policy on May 3, 2000.

S.B. 1210 would require the state Insurance Commissioner to create an HMO consumer guide. For each HMO in the state, the guide would list the: national accreditation with any limitations that were imposed, the quality-of-care rating for each HMO and a toll-free number set up by the Commissioner for inquiries or complaints. The Commissioner would be required to request information from the HMOs to determine the quality-of-care ratings. S.B. 1208 would allow enrollees who were denied coverage to obtain an external independent review of the denial. Enrollees would be required, before requesting an external review, to exhaust all internal review processes and then notify the state Insurance Commissioner. After evaluation, the Commissioner would then notify the plan of the request for an external review.

Finally in Michigan, H.B. 5576 a similar measure to S.B. 1208, was referred to the House Committee on Health Policy on May 4, 2000.

In New Hampshire, on May 11, 2000, H.B. 1240, sponsored by Representative Crosby, passed the Senate and was sent back to the House for concurrence. This measure would require health insurers to pay for services rendered by healthcare providers within 45 calendar days upon receipt of a clean written claim, or 15 calendar days upon receipt of a clean electronic claim. If the insurer fails to pay within that time-frame, the provider must send the insurer a notice that the claim must be paid within ten days or an interest payment at 1.5 percent per month will be charged along with any relevant attorney or advisor fees.

The Senate in Oklahoma refused to concur with the House amendments to S.B. 1588 on April 27, 2000. Then on May 4, 2000, the House named conferees. This measure, sponsored by Senator Monson, relates to the Oklahoma managed care act by modifying definitions of terms used in the act.

On May 2, 2000 in Rhode Island, the House passed H.B. 7468, and then on May 9, 2000 it was assigned to the Senate Committee on Corporations. Representative Ginaitti introduced this measure, which would require an HMO to provide temporary credentials to a healthcare provider while the HMO reviews the provider’s application to participate in the HMO’s network.

Mandated Benefits

Children’s Health Mandates: Lawmakers in Florida and Wisconsin took action on mandate bills specifically targeted at child health issues. Florida S.B. 164 and H.B. 93 died in committee on May 5, 2000. Both of these measures would have required certain health insurance carriers and HMOs to provide coverage for the diagnosis and treatment of autism spectrum disorder.

Florida H.B. 532, which was sponsored by Senator Dawson, was withdrawn from consideration on April 18, 2000. This measure would have required specified insurers and HMOs to provide coverage for one routine eye examination for children annually.

In Wisconsin, the Governor signed S.B. 136 into law on May 8, 2000. Senator Grobschmidt’s bill will require specified health insurers to provide coverage of childhood immunization services.

Infertility Mandates: Infertility mandate bills were considered in Florida and Oklahoma. The two bills pending in Florida, H.B. 31 and S.B. 1478, sponsored by Representative Wasserman and Senator Geller respectively, both died in committee on May 5, 2000. These bills would have required specified insurers and HMOs to provide coverage for the diagnosis and treatment of infertility under certain conditions.

In Oklahoma, the Governor signed H.B. 1338 on May 8, 2000. This legislation will require health benefit plans to provide coverage for the diagnosis and treatment of infertility. The bill specifies that only certain types of infertility treatments will have to be covered. Representative Davis was the sponsor of this measure.

Other Mandates: Florida lawmakers took action on several other mandated benefit bills during the reporting period, including the following:

Florida H.B. 1469 and S.B. 2008 both died in committee on May 5, 2000. These two bills, which were sponsored by Representative Edwards and Senator King, would have prohibited certain health insurers and managed care entities from excluding coverage of certain prescription medications through a formulary.

Also in Florida, H.B. 673 and S.B. 996 were defeated in committee on May 5, 2000. Both of these measures would have required certain insurance carriers and managed care entities to provide coverage for certain services performed by clinical laboratories under specified conditions. Representative Posey and Senator Clary originally introduced these bills.

Finally, Senator Lee’s bill, S.B. 1178, which would have mandated insurance and HMO coverage of clinical trial participation under specified circumstances, died in committee on May 5, 2000.

Medical Savings Accounts

In Minnesota, H.F. 4176 was introduced and referred to the House Committee on Health and Human Services Policy on May 9, 2000. This resolution, sponsored by Representative Broecker, memorializes Congress to enact federal legislation to remove restrictions on medical savings accounts.

Senator Runbeck in Minnesota sponsored S.F. 3832, a similar resolution to H.F. 4176, on May 4, 2000.

On May 11, 2000 in New Hampshire, H.B. 1510, sponsored by Representative Wendleboe, was reported from the Senate Committee on Insurance with the recommendation that it ought not to pass. This measure would establish a medical savings account program for state employees. Funds contributed to the medical savings account must be used exclusively for qualifying medical or surgical care. This program would be contingent on the passage of federal legislation that authorizes the expansion of access to medical savings accounts.

In New Jersey, A.B. 2344 was introduced by Assembly Member Merkt on May 8, 2000 and then referred to the Assembly Committee on State Government. This measure would establish a medical savings account plan within the State Health Benefits Commission. A high deductible health plan would then be offered to employees who decide to open a medical savings account.

Mental Health and Substance Abuse Parity

Parity legislation was addressed recently in California and Vermont. California S.B. 1764, introduced by Senator Chesbro on February 23, 2000, would require specified health insurance contracts, disability policies and self-insured employee welfare benefit plans to provide enrollees with coverage for certain types of alcohol and/or drug abuse treatment services. This legislation passed the Senate Appropriations Committee as amended on May 9, 2000. The amendment was approved on the Senate floor and the bill was sent back to the Senate Committee on Appropriations that same day.

Representative Alfano, of Vermont, sponsored H.B. 628. This bill would require each health insurance carrier in the state to annually file a report with the state Commissioner of Banking, Insurance, Securities and Health Administration concerning quality measures for mental health and substance abuse services. The report would also have to include the company’s loss ratio for mental health and substance abuse treatment expenses. On May 8, 2000 the Senate Finance Committee amended this legislation, and the amendment was approved on the Senate floor.

The Uninsured

In Colorado, H.J.R. 1048 passed the Senate Finance Committee with an amendment on May 8, 2000. The amendment was immediately approved in the Senate. Representative Tochtrop sponsored this resolution, which asks the state Healthcare Task Force to report on methods to decrease the number of uninsured individuals in the state.