Bill Text: HI HB1573 | 2017 | Regular Session | Introduced
Bill Title: Relating To Health Insurance.
Spectrum: Partisan Bill (Democrat 4-0)
Status: (Introduced - Dead) 2017-01-30 - Referred to HLT, CPC, FIN, referral sheet 6 [HB1573 Detail]
Download: Hawaii-2017-HB1573-Introduced.html
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
1573 |
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TWENTY-NINTH LEGISLATURE, 2017 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
relating to health insurance.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. Chapter 431, article 10A, Hawaii Revised Statutes, is amended by adding a new section to part I to be appropriately designated and to read as follows:
"§431:10A-A Coverage for reproductive health. (a) All individual accident and health or sickness insurance policies that provide coverage for reproductive health shall include the following services, drugs, devices, products, and procedures:
(1) Well-woman care, including screenings, assessments and counseling;
(2) Pregnancy-related services, including pregnancy tests, preconception care, abortion, and prenatal care;
(3) Counseling for sexually transmitted infections, including but not limited to human immunodeficiency virus and acquired immune deficiency syndrome;
(4) Screening for:
(A) Hepatitis B;
(B) Hepatitis C;
(C) Anemia;
(D) Urinary tract infection;
(E) Rh incompatibility;
(F) Gestational diabetes;
(G) Osteoporosis; and
(H) Cervical cancer;
(5) Screening and appropriate counseling or interventions for:
(A) Tobacco use; and
(B) Domestic and interpersonal violence;
(6) Folic acid supplements;
(7) Breastfeeding comprehensive support, counseling, and supplies;
(8) Genetic screening and counseling related to the BRCA1 or BRCA2 genetic mutations, including BRCA testing;
(9) Breast cancer chemoprevention counseling;
(10) Voluntary sterilization;
(11) Patient education and counseling on contraception; and
(12) Services related to the administration and monitoring of drugs, devices, products and services required under this section, including but not limited to:
(A) Management of side effects;
(B) Counseling for continued adherence to a prescribed regimen;
(C) Device insertion and removal;
(D) Provision of alternative contraceptive drugs, devices or products deemed medically appropriate in the judgment of the insured's provider; and
(E) Diagnosis and treatment services provided pursuant to, or as a follow-up to, a service required under this section.
(b) The coverage for reproductive health required under this section shall be in addition to any other benefits related to reproductive health required by this part, including coverage for the following:
(1) Mammogram screening under section 431:10-116(4);
(2) In vitro fertilization procedures under section 431:10A-116.5;
(3) Contraceptive services under section 431:10A-116.6; and
(4) Annual screenings for sexually transmitted infections, including screenings for human immunodeficiency virus and acquired immunodeficiency syndrome under section 431:10A-134.
(c) No policy subject to this section may impose upon an insured any deductible, coinsurance, copayment, or any other cost-sharing requirement.
(d) A health care provider shall be reimbursed for providing the services described in this section without any deduction for coinsurance, copayments, or any other cost-sharing amounts.
(e) Except as authorized under this section, no policy subject to this section may impose any restrictions or delays upon the coverage required by this section.
(f) A policy subject to this section shall cover the services, drugs, devices, products, and procedures required by this section regardless of whether the services, drugs, devices, products, and procedures are provided in the course of, or as a follow-up to, other covered services and shall reimburse the cost of the service, drug, device, product, or procedure separately from a global or bundled payment for, or a diagnostic related group code associated with, the other covered services.
(g) This section does not require a policy subject to this section to cover:
(1) Experimental or investigational treatments;
(2) Clinical trials or demonstration projects;
(3) Treatments that do not conform to acceptable and customary standards of medical practice; or
(4) Treatments for which there is insufficient data to determine efficacy.
(h) If services, drugs, devices, products, or procedures required by this section are provided by an out-of-network provider, a policy subject to this section shall cover the services, drugs, devices, products, or procedures without imposing any cost-sharing requirement upon the insured if:
(1) There is no in-network provider to furnish the service, drug, device, product, or procedure that is geographically accessible or accessible in a reasonable amount of time; or
(2) An in-network provider is unable or unwilling to provide the service in a timely manner.
(i) The requirements of this section shall apply to all policies issued or renewed in this State after June 30, 2018."
SECTION 2. Chapter 431, article 10A, Hawaii Revised Statutes, is amended by adding a new section to part II to be appropriately designated and to read as follows:
"§431:10A- Coverage for reproductive health. All group or blanket disability policies providing coverage for reproductive health shall provide coverage in compliance with section 431:10A-A."
SECTION 3. Chapter 432, article 1, Hawaii Revised Statutes, is amended by adding a new section to part VI to be appropriately designated and to read as follows:
"§432:1- Coverage for reproductive health. (a) All individual and group hospital and medical service corporation contracts that provide coverage for reproductive health shall include the following services, drugs, devices, products, and procedures:
(1) Well-woman care, including screenings, assessments and counseling;
(2) Pregnancy-related services, including pregnancy tests, preconception care, abortion, and prenatal care;
(3) Counseling for sexually transmitted infections, including but not limited to human immunodeficiency virus and acquired immune deficiency syndrome;
(4) Screening for:
(A) Hepatitis B;
(B) Hepatitis C;
(C) Anemia;
(D) Urinary tract infection;
(E) Rh incompatibility;
(F) Gestational diabetes;
(G) Osteoporosis; and
(H) Cervical cancer;
(5) Screening and appropriate counseling or interventions for:
(A) Tobacco use; and
(B) Domestic and interpersonal violence;
(6) Folic acid supplements;
(7) Breastfeeding comprehensive support, counseling, and supplies;
(8) Genetic screening and counseling related to the BRCA1 or BRCA2 genetic mutations, including BRCA testing;
(9) Breast cancer chemoprevention counseling;
(10) Voluntary sterilization;
(11) Patient education and counseling on contraception; and
(12) Services related to the administration and monitoring of drugs, devices, products and services required under this section, including but not limited to:
(A) Management of side effects;
(B) Counseling for continued adherence to a prescribed regimen;
(C) Device insertion and removal;
(D) Provision of alternative contraceptive drugs, devices or products deemed medically appropriate in the judgment of the insured's provider; and
(E) Diagnosis and treatment services provided pursuant to, or as a follow-up to, a service required under this section.
(b) The coverage for reproductive health required under this section shall be in addition to any other benefits related to reproductive health required by this part, including coverage for the following:
(1) Mammogram screening under section 432:1-605;
(2) In vitro fertilization procedures under section 432:1-604;
(3) Contraceptive services under section 432:1-604.5; and
(4) Annual screenings for sexually transmitted infections, including screenings for human immunodeficiency virus and acquired immunodeficiency syndrome under section 432:1-618.
(c) No contract subject to this section may impose upon a member any deductible, coinsurance, copayment, or any other cost-sharing requirement.
(d) A health care provider shall be reimbursed for providing the services described in this section without any deduction for coinsurance, copayments, or any other cost-sharing amounts.
(e) Except as authorized under this section, no contract subject to this section may impose any restrictions or delays upon the coverage required by this section.
(f) A contract subject to this section shall cover the services, drugs, devices, products, and procedures required by this section regardless of whether the services, drugs, devices, products, and procedures are provided in the course of, or as a follow-up to, other covered services and shall reimburse the cost of the service, drug, device, product, or procedure separately from a global or bundled payment for, or a diagnostic related group code associated with, the other covered services.
(g) This section does not require a contract subject to this section to cover:
(1) Experimental or investigational treatments;
(2) Clinical trials or demonstration projects;
(3) Treatments that do not conform to acceptable and customary standards of medical practice; or
(4) Treatments for which there is insufficient data to determine efficacy.
(h) If services, drugs, devices, products, or procedures required by this section are provided by an out-of-network provider, a contract subject to this section shall cover the services, drugs, devices, products, or procedures without imposing any cost-sharing requirement upon the member or beneficiary if:
(1) There is no in-network provider to furnish the service, drug, device, product, or procedure that is geographically accessible or accessible in a reasonable amount of time; or
(2) An in-network provider is unable or unwilling to provide the service in a timely manner.
(i) The requirements of this section shall apply to all contracts issued or renewed in this State after June 30, 2018."
SECTION 4. Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:
"§432D-23 Required provisions and benefits. Notwithstanding any provision of law to the contrary, each policy, contract, plan, or agreement issued in the State after January 1, 1995, by health maintenance organizations pursuant to this chapter, shall include benefits provided in sections 431:10-212, 431:10A-115, 431:10A-115.5, 431:10A-116, 431:10A-116.2, 431:10A-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, 431:10A-121, 431:10A-122, 431:10A-125, 431:10A-126, 431:10A-132, 431:10A-133, 431:10A-140, 431:10A-A, and 431:10A-134, and chapter 431M."
SECTION 5. In codifying the new section added by section 1 of this Act, the revisor of statutes shall substitute the appropriate section number for the letter used in designating the new section in this Act.
SECTION 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 7. This Act shall take effect upon its approval.
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INTRODUCED BY: |
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Report Title:
Insurance; Reproductive Health
Description:
Requires health insurers to provide coverage for reproductive health.
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
