ࡱ>  ]6bjbj ID'.5. . qqqqq8$6(QQQG6I6I6I6I6I6I6\8:JI6qQQI6qq4^6qq5G6.1 kL\ӕo0:5t6060lH;vH;H!1!1H;q51XQvTD_sQQQI6I6pQQQ6H;QQQQQQQQQ. 7:   WASHINGTON ASSOCIATION OF HEALTH UNDERWRITERS LEGISLATIVE UPDATE February 23, 2009 House Committees Kill Hundreds of Bills at Deadline for ApprovalSenate Committees have Until February 25 to Approve Measures Although the House and Senate approved a resolution setting February 25 as the last day for passing bills out of committee in the house of origin, the House of Representatives implemented its own cut-off date on Friday, February 20. Hundreds of bills introduced in the House were killed on Friday when they were not approved before the deadline. Senate committees are rushing to complete final action on priority measures before their deadline on Wednesday, February 25. Hundreds of Senate bills will not make it. Having reached the first cut-off date, action now turns to the fiscal committees in the House and Senate which have until Monday, March 2 to approve bills that that pose a fiscal impact for the state. Following the cut-off for fiscal committees, all legislative activity will turn to the floors of the House and Senate. The cut-off resolution calls for bills in the house of origin to be approved by Thursday, March 12 at 5:00 p.m. With rare exception, bills failing to be approved by the cut-off dates will not be considered further this session. Although thousands of bills have been introduced this year, the process of winnowing them down has begun. Budget Woes Stimulate Discussion of Possible Tax Increases State budget writers got more bad news this week as state officials released revised estimates showing that the budget shortfall has ballooned from about $6 billion in December to $8.3 billion. The current general fund budget is just over $33 billion. Budget leaders in the House and Senate plan to release budget proposals this week to show what would happen if the new budget plan is based on budget cuts alone. Budget leaders say that they are likely to draw up a list of priority programs that will be cut unless new taxes are approved to pay for themand this budget and tax package will be submitted to voters in November. The Tacoma News Tribune reported this week that unions and other stakeholders are holding "focus groups" in communities. They're trying to figure out how much a tax increase the public can stomach, which taxes they would vote to increase or which tax exemptions they would vote to remove, which wholesome programs the money should be spent on to make the taxes more palatable and how much money the tax increases should raise. $1 billion? $1.5 billion? $2 billion? Tax increases will not be popular, and it is certain that business groups will actively defend against raising taxes as businesses are struggling with slowing sales and a sluggish economy. House Committee Considers Measure to Force School Districts and ESDs to Purchase Health Benefits though the PEBB On Wednesday, February 18, the House Ways and Means Committee held a hearing to consider HB 1940a 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 Health Care & Wellness Committee held a hearing on a related billSB 5491on Wednesday, February 11. Neither bill has been scheduled for a vote. Senate Committee Approves Amended Bill on Organ Transplant Benefits On Thursday, February 19, the Senate Health & Long Term Care Committee approved an amended version of SB 5725a measure that was introduced to prohibit health plans from imposing separate lifetime limits on benefits for organ transplants. The amendment adopted by the committee allows separate lifetime limits on organ transplants, but such limits can not be lower than $350,000. Health plan representatives testified with concerns about the original 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 now goes to the Senate Rules Committee in preparation for consideration by the full Senate. Measure to Increase Coverage for Neurodevelopmental Therapies Referred to House Health and Human Services Appropriations CommitteeFaces Fiscal Committee Deadline Although 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 18the bill has been referred to the House Health and Human Services Appropriations Committee for consideration of a $1.9 million fiscal note relating to costs that the measure would pose for the state. With the state struggling with massive budget shortfalls, the chair of the committee has made it clear that bills posing a fiscal impact must be offset with other spending reductions. It is unclear whether HB 1412 will be scheduled for hearing. If passed, 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 committeeperhaps because its fiscal note exceeds $16 million for the 2009-11 biennium. The House Health Care Committee killed HB 1210the House counterpart to SB 5203when it was not considered at hearing and approved prior to the February 20 cut-off date for House committee action. Senate Ways and Means Committee Approves Measure Regulating Discount Plans On Thursday, February 19, the Senate Ways and Means Committee voted to recommend approval of SB 5480a proposal introduced at the request of Insurance Commissioner Mike Kreidler to regulate certain Discount Health Plans. The measure was previously approved by the Senate Health and Long Term Care Committee. 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 Senate Health and Long Term Care 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 the Ways and Means Committee 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 Rules Committee. House Committee Kills Controversial Retainer Medicine BillAmended Senate Version Added to Senate Floor Calendar for Possible Consideration The House Health Care & Wellness Committee killed HB 1459 when it was not brought to a vote before the cut-off for committee approval on Friday, February 20. The committee held a hearing for the bill on Thursday, February 12. At the hearing, representatives from the OIC expressed concern about continued growth and expansion of direct practice activities. Health plan 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. The Senate Rules Committee has added SB 5436 to the Senate floor calendar. The bill could be brought to a vote of the full Senate at any time. SB 5436 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. 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. House Committee Kills Controversial Eye-Care Referral Bill The House Health Care & Wellness Committee has killed HB 1396a controversial bill introduced at the request of the Washington Optometric Association. The bill would have required health plans to allow direct access to participating eye care providers without the necessity of prior referral. At a hearing on January 30, health plan and employer representatives opposed the measure. The measure was killed when it was not brought to a vote and approved prior to the February 20 cut-off. Senate Committee Considers Bill Relating to Coverage for Young Adults On Wednesday, February 18 the Senate Health & Long Term Care Committee held a hearing to consider SB 5052a measure that would allow health carriers to design and offer a separate health plan targeted at young adults between the ages of 18-34. The bill was introduced by Senator Linda Evans Parlette (R, Wenatchee), to implement one of the recommendations resulting from the Governors Blue Ribbon Commission on Health Care Costs and Access. Health plans, agents and brokers, and business groups in testifying in support of the measure. The bill has not been scheduled for a vote.     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