Bill Text: DE SB134 | 2009-2010 | 145th General Assembly | Draft
Bill Title: An Act To Amend Title 28 Of The Delaware Code Relating To Nonprofit Charitable Gaming.
Spectrum: Moderate Partisan Bill (Democrat 14-3)
Status: (Passed) 2009-07-06 - Signed by Governor [SB134 Detail]
Download: Delaware-2009-SB134-Draft.html
|
SPONSOR: |
Sen. Bushweller & Rep. B. Short |
|
Reps. Barbieri & Walker |
|
DELAWARE STATE SENATE 146th GENERAL ASSEMBLY |
|
SENATE BILL NO. 134 |
|
AN ACT TO AMEND TITLE 18 OF THE DELAWARE CODE RELATING TO HEALTH INSURANCE. |
WHEREAS Delaware law does not require health insurance insurers to accept the assignment of benefits provided for in health insurance policies when such assignments are properly executed by patients to direct that insurers make benefit payments directly to physicians and other health care providers;
WHEREAS insurer payments of benefits to patients who have executed assignment of benefit forms is detrimental to the patient-physician and other health care provider relationship; and
WHEREAS Insurance Department Regulation 1301 provides procedures for the arbitration of payment disputes between out of network emergency care providers and carriers; and
WHEREAS Section7.6 of Department of Insurance Regulation 1301 requires that prior to arbitration, carriers pay directly to non-network emergency care providers, an amount defined in Regulation 1301; and
WHEREAS it is appropriate to incorporate Section 7.6 of Regulation 1301 in Title 18;
NOW, THEREFORE:
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:
Section 1. Amend Title 18 of the Delaware code by deleting §720 in its entirety and by replacing it with the following:
"§720. Assignability and Payment of Benefits to Health Care Providers
(a) Except as provided in §2720(b), a policy may be assignable or not assignable, as provided by its terms. Subject to its terms relating to assignability, a life or health insurance policy, whether heretofore or hereafter issued, under the terms of which the beneficiary may be changed upon the sole request of the insured or owner may be assigned either by pledge or transfer of title by an assignment executed by the insured or owner alone and delivered to the insurer, whether or not the pledgee or assignee is the insurer. Any such assignment shall entitle the insurer to deal with the assignee as the owner or pledgee of the policy in accordance with the terms of the assignment until the insurer has received at its home office written notice of termination of the assignment or pledge or written notice by or on behalf of some other person claiming some interest in the policy in conflict with the assignment.
(b) An insurer shall pay benefits provided for in a health insurance policy directly to a physician or other health care provider, and the insurer is relieved of any and all obligation to pay such benefits to the insured or owner of the health insurance policy if:
(1) the insured or owner of the policy makes a written assignment of such benefits payable to the physician or other health care provider; and
(2) the assignment is delivered to the insurer prior to or with the physician's or other health care provider's claim for benefits;
(c) The provisions of §720(b) shall not apply to any payment due a provider of emergency services pursuant to 18 Del. C. §§3349(b), (c), 3565(b) or (c).
(d) The Insurance Commissioner is authorized to adopt regulations concerning the provisions of this Section 2720."
Section 2.Amend §3349 of Title 18 of the Delaware code by inserting a new §3349(c) to read as follows:
"(c) Prior to a determination by the Insurance Commissioner (or the Commissioner's designee) of those charges and rates allowed by the providers of emergency services pursuant to §3349(b), the insurer will pay directly to the non-network emergency care provider the highest allowable charge for each emergency care service allowed by the insurer for any other network or non-network emergency care provider during the full twelve month period immediately prior to the date of each emergency care service performed by the non-network provider.The Insurance Commissioner is authorized to adopt regulations concerning the provisions of this Section 3349(c)."
Section 3.Amend §3565 of Title 18 of the Delaware code by inserting a new §3565(c) to read as follows:
"(c) Prior to a determination by the Insurance Commissioner's (or the Commissioner'sdesignee) of those charges and rates allowed by the providers of emergency services pursuant to §3565(b), the insurer will pay directly to the non-network emergency care provider the highest allowable charge for each emergency care service allowed by the insurer for any other network or non-network emergency care provider during the full twelve month period immediately prior to the date of each emergency care service performed by the non-network provider.The Insurance Commissioner is authorized to adopt regulations concerning the provisions of this Section 3565(c)."
Section 4.If any provision of this Act or the application of any section or part thereof to any person or circumstance is held invalid, such invalidity shall not affect other provisions or applications of this Act that can be given affect without the invalid provision or application.
SYNOPSIS
|
This bill would amend the insurance code to allow patients to assign their right to receive benefits under their health insurance policies to physicians and other health care providers.In addition, this bill would incorporate the provisions of Section 7.6 of Insurance Department Regulation 1301 into the insurance code. |
Author: Senator Bushweller
