ࡱ> tvu c bjbj I,-5. . qqqqq86(III55555557s:J5qII5qq45}}}qq5}5}}8.0 @?d/:5506.0l:p:H00:q0HIvT}DW<III55jIII6:IIIIIIIII. 7:   WASHINGTON ASSOCIATION OF HEALTH UNDERWRITERS LEGISLATIVE UPDATE February 9, 2009 House Health Care & Wellness Committee Considers Measure to Increase Coverage for Neurodevelopmental Therapies The House Health Care & Wellness Committee held a hearing on Thursday, February 5 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. Health plan representatives provided testimony on the measure, expressing appreciation to the bills sponsor for working to find measured ways to improve coverage and benefits for neurodevelopmental services. Although the Senate Health & Long Term Care Committee has held a hearing to consider a sweeping measure (SB 5203) that would mandate costly and controversial services with respect to autism, the bill has not been scheduled for a vote in committee. House Committee Considers Controversial Bills Relating to Association Health Plans The House Health Care & Wellness Committee held a hearing on Friday, February 6 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. Insurance Commissioner Mike Kreidler testified in support of each of the billsarguing that association group plans have grown in recent years, while the small group market has declined. He expressed concern about the health of the small group market. A wide variety of employer associations argued against both bills. They argued that association group plans have grown because they have proven to be cost-effective, and have allowed many employers to provide coverage for the first time. Health plan representative also testified against the bills. If the bills do not move forward in their current form, it appears likely that legislators will prepare an amendment asking for data to be provided to the Insurance Commissioner with respect to association group health plans. House Committee Considers Measure Changing Eligibility Standards for the Washington State Health Insurance Pool The House Health Care & Wellness Committee held 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. Senate Committee Considers Discount Plans The Senate Health and Long Term Care Committee held 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. Commissioner Kreidler testified in support of the measure, indicating that consumers are frequently confused by marketing materials relating to discount programs, and that his office does not currently have regulatory authority over them. The Washington Association of Health Underwriters also testified in support of the measure, arguing that licensed agents and brokers must adhere to regulatory standards with respect to their actions, but that those who market discount programs are not subject to any standards or requirements, and that consumers can easily become confused about what is being sold. Controversy Continues Over Bills to Expand Retainer Medicine Plans The Senate Health & Long Term Care Committee held a hearing on Thursday, February 5 to consider SB 5436a measure that would allow retainer medicine plans to expand services that are currently allowed. Under the bill, direct practices furnishing primary care would be allowed to pay for charges associated with routine lab and imaging services. The bill would also partially lift restrictions on direct practices from accepting payments for services from insurers. The measure further provides that direct practices would be allowed to accept payments from self-insured plans, and would allow direct practices to accept payment of direct fees from employers. Health plan representatives testified in opposition to the measurearguing that the bill prematurely expands the authority of retainer practice plans before the first report from the OIC is due, and that such plans are not required to comply with a wide array of regulatory requirements that are imposed on health carriers. The House Health Care & Wellness Committee has scheduled a hearing on the House version of the bill (HB 1459) for Thursday, February 12.     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