ࡱ> z|{ *bjbj I8"5. . qqqqq8$6(QQQ#6%6%6%6%6%6%688:J%6qQQ%6qq4:6qq}5#6.0 @bdS0:i5P6060l$;v$;H11$;q1PQhJ<?QQQ%6%6lpQQQ6$;QQQQQQQQQ. 7:   WASHINGTON ASSOCIATION OF HEALTH UNDERWRITERS LEGISLATIVE UPDATE February 16, 2009 Senate Committee Considers Measure to Force School Districts and ESDs to Purchase Health Benefits though the PEBB On Wednesday, February 11, the Senate Health and Long Term Care Committee held a hearing to consider SB 5491a measure that would compel school districts and ESDs to purchase health benefits through the state. WAHU, together with representatives of the Washington Education Association, other union groups, and some school districts, testified in opposition to the bill, arguing that school districts and ESDs should continue to have the choice of participating in PEBB programs or finding other options to serve their needs. The Senate bill has not been scheduled for a vote. The House Ways and Means Committee has scheduled a hearing on Wednesday, February 18 to consider a similar measureHB 1940. Senate Committee Considers Bill to Remove Limits on Organ Transplant Benefits On Wednesday, February 11, the Senate Health & Long Term Care Committee held a hearing to consider SB 5725a measure that would prohibit health plans from imposing separate lifetime limits on benefits for organ transplants. AHIP and other health plan representatives testified with concerns about the measure, indicating that unrestricted organ transplant benefits would result in higher premium costs, and that in some cases the measure could result in a patient exhausting all lifetime medical benefits. The fiscal note on the bill shows no cost to the state because the programs administered by the Health Care Authority do not currently have separate limits on organ transplant benefits. The measure has not been scheduled for a vote. House Health Care & Wellness Committee Approves Measure to Increase Coverage for Neurodevelopmental Therapies On Friday, February 13, the House Health Care & Wellness Committee voted to give a do pass recommendation for 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. Because the bill carries a fiscal note of over $1.9 million in costs to the state for the 2009-11 biennium, the measure will almost certainly be referred to the House Ways and Means Committee for review. 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 committeeperhaps because its fiscal note exceeds $16 million for the 2009-11 biennium. House Committee Prepares Data Call Amendment for Measure on Association Health Plans On Friday, February 13, The House Health Care & Wellness Committee gave approval to an amended version of HB 1714, and passed the measure out of committee. The amendment approved by the committee replaced all of the language of the bill as it was introduced with language calling for data on association health plans to be provided to the Office of the Insurance Commissioner to facilitate a better understanding of the association health plan market. The committee previously held a hearing to consider the measure, along with HB 1712. As introduced, the controversial measures 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. As introduced, HB 1714 would have imposed similar community rating standards for association group plans that exist for the rest of the market. The measure would have also imposed 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. AHIP and other health plan representative also testified against the bills. Senate Committee Approves Measure Regulating Discount Plans On Tuesday, February 10, the Senate Health and Long Term Care Committee voted to recommend approval of SB 5480a 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 committee attached an amendment to the measure, clarifying that the cost of OIC examinations relating to discount plans must be borne by the organization, and not the OIC. The amendment further called for disclosure provisions to reflect the standards set in the NAIC model. When the measure was considered at hearing, 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. The bill has been referred to the Senate Ways and Means Committee for consideration of a modest fiscal note. Senate Committee Approves Amendments to Controversial Retainer Medicine Bill On Friday, February 13, the Senate Health & Long Term Care Committee gave a do pass recommendation to an amended version of 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. The amendments approved by the committee clarify the relationship that direct practices would have with employers if they accept payments from employers, and provide for the OIC to work with HMOs to determine how they might offer direct practice services under these provisions. AHIP and other health plan representatives testified in opposition to the measure when it was considered at hearingarguing 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 held a hearing on the House version of the bill (HB 1459) on Thursday, February 12. At the hearing in the House committee, representatives from the OIC expressed concern about continued growth and expansion of direct practice activities. AHIP and other carrier representatives testified in opposition to the measure, and suggested that if it moves forward, other regulated health plans should be authorized to provide direct practice programs as well.     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