IN SB0249 | 2022 | Regular Session
Status
Spectrum: Moderate Partisan Bill (Republican 8-2)
Status: Engrossed on February 2 2022 - 50% progression, died in committee
Action: 2022-02-07 - First reading: referred to Committee on Financial Institutions and Insurance
Pending: House Financial Institutions and Insurance Committee
Text: Latest bill text (Engrossed) [PDF]
Status: Engrossed on February 2 2022 - 50% progression, died in committee
Action: 2022-02-07 - First reading: referred to Committee on Financial Institutions and Insurance
Pending: House Financial Institutions and Insurance Committee
Text: Latest bill text (Engrossed) [PDF]
Summary
Health insurance transparency. Specifies that the compliance of a practitioner and a provider facility with federal law meets the good faith estimate requirements concerning health service costs. Allows the commissioner of the department of insurance to issue an order to discontinue a violation of a law (current law specifies orders or rules). Requires a domestic stock insurer to file specified information with the department of insurance. Prohibits a health plan from requiring a health care provider to submit a prior authorization request to a third party and requires the health plan to transmit the request to the third party through secure electronic transmission. Amends the deadline by which a health plan must respond to a nonurgent care prior authorization request. Requires a health plan to offer a health care provider that submitted a prior authorization and received an adverse determination the option to request a peer to peer review by a clinical peer concerning the adverse determination. Requires a health plan to post notice of a technical issue with its claims submission system on the health plan's Internet web site. Requires a health plan to post on its Internet web site not later than February 1 of each year: (1) the 30 most frequently submitted CPT codes in the previous calendar year; and (2) the percentage of the 30 most frequently submitted CPT codes that were approved in the previous calendar year. Establishes an approval process for a health plan's proposed premium rate increase of 5% or greater as compared to the previous calendar year. Prohibits an insurer and a health maintenance organization from altering a CPT code for a claim unless the medical record of the claim has been reviewed by an employee who is a licensed physician. Requires an insurer and a health maintenance organization to provide a contracted provider with a current reimbursement rate schedule: (1) every two years; and (2) when three or more CPT code rates change in a 12 month period. Urges the study by an interim committee of prior authorization exemptions for certain health care providers.
Title
Health insurance transparency.
Sponsors
Roll Calls
2022-02-01 - Senate - Senate - Third reading (Y: 49 N: 0 NV: 0 Abs: 0) [PASS]
2022-01-26 - Senate - Senate - Committee Vote (Y: 10 N: 1 NV: 0 Abs: 0) [PASS]
2022-01-26 - Senate - Senate - Committee Vote (Y: 10 N: 1 NV: 0 Abs: 0) [PASS]
History
| Date | Chamber | Action |
|---|---|---|
| 2022-02-07 | House | First reading: referred to Committee on Financial Institutions and Insurance |
| 2022-02-02 | Senate | Referred to the House |
| 2022-02-01 | Senate | Cosponsors: Representatives Lehman, Carbaugh, Schaibley |
| 2022-02-01 | Senate | House sponsor: Representative Heine |
| 2022-02-01 | Senate | Third reading: passed; Roll Call 163: yeas 49, nays 0 |
| 2022-01-31 | Senate | Senator Randolph added as coauthor |
| 2022-01-31 | Senate | Senators Becker and Melton added as coauthors |
| 2022-01-31 | Senate | Senator Crider added as third author |
| 2022-01-31 | Senate | Amendment #1 (Brown L) prevailed; voice vote |
| 2022-01-31 | Senate | Second reading: amended, ordered engrossed |
| 2022-01-27 | Senate | Committee report: amend do pass, adopted |
| 2022-01-20 | Senate | Senator Charbonneau added as second author |
| 2022-01-10 | Senate | First reading: referred to Committee on Health and Provider Services |
| 2022-01-10 | Senate | Authored by Senator Brown L |
