ࡱ> tvs R'bjbj I45. . qqqqq8$6t(QQQ"6$6$6$6$6$6$67:J$6q QQ  $6qq496 qq|5 "6.1 bpb0:h5O6060l:v:H11:q(1@Qrc\NQQQ$6$6{pQQQ6    :QQQQQQQQQ. 7:   WASHINGTON ASSOCIATION OF HEALTH UNDERWRITERS LEGISLATIVE UPDATE February 2, 2009 Senate Committee Considers Bill Mandating Benefits for Autism-Related Services The Senate Health & Long Term Care Committee held a hearing this week to consider SB 5203a measure that would establish sweeping mandates for new benefits for autism-related services. The Senate bill, and HB 1210, its counterpart that has been filed in the House, would require health plans, including those offered to public employees and their dependents, to include coverage for the diagnosis and treatment of autism spectrum disorders in individuals under the age of 21. The bills would impose a benefit of up to $50,000 per year, and they would preclude any limit on the number of visits an individual may make to an autism services provider. Covered treatments would include applied behavioral analysis, pharmacy, psychiatric, physiological, and therapeutic care, as well as any other care determined by the Department of Health to be medically necessary. Health plan representatives testified with concerns about the measure, indicating that the bill would be costly for employers and individuals that buy health coverage. Concern was also raised that the bill requires payment for certain controversial therapies that have not yet been assigned procedure codes, and that the measure fails to make it clear that only licensed or regulated health care providers would be authorized to deliver covered services. Fiscal notes have been requested to evaluate cost impacts on state programs, and early estimates suggest that the HCA will estimate a $16 million impact for state programs. House Health Care & Wellness Committee to Consider Measure to Increase Coverage for Neurodevelopmental Therapies The House Health Care & Wellness Committee has scheduled a hearing to consider HB 1412a measure that would amend the current mandated benefit for neurodevelopmental therapies by extending the age for those eligible for services to 18. The new requirements would become effective for plans on or after January 1, 2011. The bill would direct the Department of Health to determine the most appropriate means to regulate providers who use applied behavioral analysis for the treatment of autism, and identify therapies that should be considered to be in accordance with generally accepted standards of practice. The measure was introduced as an alternate proposal to the bills that would specifically mandate coverage for autism services. The hearing has been scheduled for Thursday, February 5 at 8:00 a.m. Senate Committee Considers Bill to Mandate Benefits for Language Translation Services On Wednesday, January 28 the Senate Health & Long Term Care Committee held a hearing to consider SB 5140a measure that would mandate coverage for language translation services for covered individuals that have limited proficiency in the English language. Health plan representatives testified in opposition to the measure, expressing concern about the prospective costs and operational complexities that are presented by the proposal. It was also pointed out the bill does not apply to the States Uniform Medical Plan, and would only apply to the Basic Health Plan if funds for implementation are available. SB 5140 and its counterpart in the House, HB 1519, would require health plans to provide interpretation services or reimburse health care providers for providing interpretation services to covered individuals who have limited proficiency in the English language. The requirements would become effective on health plans on or before January 1, 2011. Senate Committee Considers Bill on Administrative Simplification and Streamlining The Senate Health & Long Term Care Committee held a hearing on Monday, January 26 to consider SB 5346a measure that is intended to establish streamlined and uniform standards for the administration of private and public health care programs. AHIP and other health carrier representatives testified in support of the goals of the measure, but expressed concern about some of the details of the bill. They also urged the committee to continue to include state programs within the requirements of the measure. The bill directs the Insurance Commissioner to designate one or more lead organizations to coordinate the development of processes, guidelines, and standards to streamline health care administration for use by payers and providers of health care services in Washington State. The bill also directs the Department of Social and Health Services, the Department of Labor and Industries, and the Health Care Authority to cooperate with the OIC in this process. The measure has not yet been scheduled for a hearing. House Committee to Consider Controversial Bills Relating to Association Health Plans The House Health Care & Wellness Committee has scheduled a hearing to consider HB 1712 and HB 1714controversial measures that would change standards for association health plan operations in Washington State. HB 1712 would require association health plans to be considered for rating and regulatory purposes to be large group plans in which the entire association or member-governed group constitutes the group. Such plans would be subject to the community rating standards applicable to the large group market. HB 1714 would impose similar community rating standards for association group plans that exist for the rest of the market. The measure would also impose rate bands. Employer associations have already indicated that they will vigorously argue against both bills. The hearing is scheduled for Friday, February 6 at 1:30 p.m. House Committee to Consider Measure Changing Eligibility Standards for the Washington State Health Insurance Pool The House Health Care & Wellness Committee has scheduled a hearing to consider HB 1713a measure that would revise the eligibility requirements for the Washington State Health Insurance Pool to allow for Medicare-eligible individuals who do not have a reasonable choice of more than one Medicare part C option, at least one of which is not a private fee for service plan. The bill would also require the Board of the WSHIP to conduct a study of options for equitable, stable, and broad-based funding sources for the operation of the pool. The Board of the WSHIP would be authorized to solicit funds to conduct the study. The hearing has been scheduled for Friday, February 6 at 1:30 p.m. Senate Committee to Consider Discount Plans The Senate Health and Long Term Care Committee has scheduled a hearing to consider a proposal introduced at the request of Insurance Commissioner Mike Kreidler to regulate certain Discount Health Plans. SB 5480 would establish consumer protection standards and new regulatory requirements with respect to health programs that market discounts on charges for health care services. The measure would require such programs to be licensed by the OIC before conducting business in the state, and current programs would have six months from the effective date of the act to submit an application and come into compliance. The bill is scheduled for hearing on Monday, February 2 at 1:30 p.m. Senate to Consider Measure Relating to the Individual Market Standard Health Questionnaire The Senate Health & Long Term Care Committee has scheduled a hearing to consider SB 5406a measure that provides that individuals with at least 24 months of group coverage who are eligible to purchase COBRA coverage, or who drop COBRA coverage, are not required to take the standard health questionnaire when they apply for individual health insurance coverage. The hearing on the measure has been scheduled for Thursday, February 5 at 10:00 a.m. The House Health Care & Wellness Committee has already held a hearing to consider HB 1401the House counterpart to SB 5406, and approved the bill on Friday, January 30.     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