HB2137 - 452R - House Bill Summary

House of Representatives

HB 2137

~~health care services organizations; services~~

(NOW: services; health care services organizations)

Sponsors: Representative Carpenter; Poelstra

DPA S/E	Committee on Financial Institutions & Insurance
DPA	Caucus and COW
DPA	Third Read
DPA	As Passed the House
X	As Transmitted to the Governor

HB 2137 eliminates the statutory definition of basic health care services and retains the rulemaking authority of the director to carry out the provisions of statute that address basic health care services.

History

Laws 2000, Chapter 355 transferred regulatory oversight of health care service organizations (HCSO) from the Department of Health Services (DHS) to the Department of Insurance (DOI). One provision of the legislation was the transfer of responsibility to DOI of determining what "basic health care services" are required to maintain an HCSO's enrollees in good health. The statutes generally prescribe items such as emergency care, inpatient hospital and physician care and outpatient medical services as standard basic health care services. The Department of Insurance has moved forward with the regulatory and rulemaking authority duties that outline basic health care services. However, existing rules adopted by DOI (R20-6-1906) already contain the same basic health care service items in greater detail. The proposed legislation eliminates the statutory definition of basic health care services and retains the rulemaking authority of the director to carry out the provisions of statute that address basic health care services.

Provisions

· Eliminates the statutory definition of "basic health care services" and other references in statute of basic services.

· Clarifies that a health care plan shall include health care services required in statute or in any ruled adopted pursuant to the article.

· Requires health care plans to provide an appropriate mechanism to achieve an effective health care plan as a condition of certificate of authority.

· Provides that the director may adopt rules to carry out the provisions of statute. The bill specifies that the department follows the rulemaking procedures established in Title 41, chapter 6 (Administrative Procedures).

· Makes technical and conforming changes.

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· 45th Legislature