| OCR Text |
Show of Representatives. It carried a $315 million fiscal note, reportedly the largest fiscal note in the history of the Utah Legislature. HB 120~Health Insurance Amendments Sponsored by Representative R. Mont Evans, HB 120 was one of the three bills recommended by the Access to Health Care Task Force. The legislation contained three provisions. First, it required that health insurance carriers offering dependent coverage must offer coverage for all unmarried dependents up to 26 years of age. Second, it provided for "continuity of coverage" between health insurance plans. Under the bill, once a beneficiary or dependent had met the applicable waiting period for one insurance plan, a new insurance plan could not impose a new waiting period, so long as there had been no more than 30 days interruption in coverage. Third, HB 120 amended the so called "anti-discrimination" section of the Utah Insurance Code. This law requires indemnity carriers to pay for services of any licensed health care provider who provides a service, within the provider's legal scope of practice, that is included in the carriers' benefit plan. It also requires preferred provider organizations (PPO) to designate, as a preferred provider, any provider who is willing and able to meet the terms and conditions of the PPO. HB 120 attempted to change the statute to reflect what the task force was told about how the law was being interpreted. The statute provides that "any health care provider licensed to treat any illness or injury within the scope of their practice, who is willing and able to meet the terms and conditions established by the insurer for designation as a preferred health care provider, shall be able to apply for and receive designation as a preferred health care provider (Utah Code, Subsection 31A-22-617 (7))." On its face, the statute seems to require any provider who is willing to "meet the terms and conditions" of the PPO to be designated as a preferred provider. However, the task force was told that the statute was interpreted to mean that a PPO could limit the number of providers within a class that it accepted onto its panel. Based on reports that this was how the statute was being interpreted, the task force amended the law to provide that a PPO may discriminate within a class of providers, but not between classes of providers. Despite earlier commitments by some segments of the business and insurance communities to support the bill, they opposed HB 120 as a whole. After extensive committee and floor debate, HB 120 failed to pass the House of Representatives by one vote. It was never considered by the Senate. SB 59-Medicaid Expansion Under this bill, also approved by the Access to Health Care Task Force, Senator Holmgren provided Medicaid eligibility for all persons who were aged, blind, and disabled who lived in households with incomes below the federal poverty level. As originally recommended by the task force, the legislation also directed the department to apply for authority to expand eligibility for Medicaid for certain low income persons (single adults, couples without children, etc.) not traditionally served by the program. Due to its budgetary impact, the bill did not pass. SB 153-Small Employer Health Insurance Coverage This bill was reviewed, but not adopted, by the Access to Health Care Task Force. Senator Holmgren decided to introduce the legislation to determine the type of reaction major health insurance reform legislation would receive. SB 153 was based on model legislation adopted by the National Association of Insurance Commissioners. The bill attempted to solve many of the problems that were perceived to plague the small group health insurance market. It contained major changes in how health insurance for small firms was marketed, priced, and administered. Complex and technically worded, this 30 page bill was actively opposed by the Utah Health Insurance Association on the basis of its content. Utah's Health: An Annual Review 1993 105 |
