Bill
Number: S.B. 1471
Barto
Floor Amendment
Reference
to: HEALTH AND HUMAN SERVICES Committee amendment
Amendment
drafted by: Legislative Council
FLOOR
AMENDMENT EXPLANATION
1)
Requires
the Department of Insurance (DOI) to exempt any health insurer from having to
disclose certain health care service cost and quality information requested by
an enrollee, if the insurer includes an explanation as to why such information
would be too difficult to provide.
2)
Requires
the insurer to annually notify eligible enrollees about the availability of any
interactive mechanism to compare allowed amounts among network facilities and
providers.
3)
Allows,
beginning January 1, 2020, DOI to expand the list of health care services that
will be considered comparable health care services.
4)
Defines
allowed amount and comparable health care services.
5)
Makes
technical and conforming changes.
Page 1, between lines 4 and 5, insert:
"Line
19, strike "a"; strike "facility"
insert "facilities"
Line 20,
strike "provider" insert "providers";
strike "or health care facilities"
Line 25,
strike "health care facility or""
Lines 15 and
16, strike "if the health insurer has provided sufficient
evidence" insert "that includes an explanation"
Between
lines 17 and 18, insert:
"D. A health insurer, annually at enrollment or renewal, shall
provide notice about the availability of any interactive mechanism to compare
allowed amounts among network health care facilities or health care providers
to each enrollee who is enrolled in a health care plan that is eligible.
E. Beginning
January 1, 2020, the department may expand the list of health care services
that will be considered comparable health care services for the purposes of
this section."
Between
lines 18 and 19, insert:
"Between
lines 3 and 4, insert:
"1. "Allowed amount" means the contractually
agreed on amount paid by a health insurer to a health care provider or health
care facility participating in the health insurer's network or the amount the
health insurer is required to pay under the health care plan.
2. "Comparable
health care services" means any covered nonemergency health care service
or bundle of services, including at least the following:
(a) Physical
and occupational therapy services.
(b) Obstetrical
and gynecological services.
(c) Radiology
and imaging services.
(d) Laboratory
services.
(e) Infusion
therapy.
(f) Inpatient
and outpatient surgical procedures."
Renumber to
conform"
Page 2,
between lines 12 and 13, insert:
"After
line 43, insert:
"C. Beginning January 1, 2020, the department may expand the
list of health care services that will be considered comparable health care
services for the purposes of this section."
Reletter to
conform"
Amend title to conform