STATE OF OKLAHOMA

1st Session of the 52nd Legislature (2009)

SENATE BILL 821	By:	Johnson (Constance)

AS INTRODUCED

An Act relating to insurance; stating legislative intent; defining terms; requiring health benefit plan to provide coverage for certain health care therapies; providing for exceptions; requiring the Insurance Commissioner to promulgate certain rules; providing for codification; and providing an effective date.

BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 6060.19 of Title 36, unless there is created a duplication in numbering, reads as follows:
A.  It is the intent of the Oklahoma Legislature to acknowledge that all conditions do not have a medical cure and that health benefit plans should provide coverage for alternative and complementary health care therapies in order to assist in the management and treatment of such conditions.
B.  As used in this section:
1.  “Health benefit plan” means group hospital or medical insurance coverage, a not-for-profit hospital or medical service or indemnity plan, a prepaid health plan, a health maintenance organization plan, a preferred provider organization plan, the State and Education Employees Group Health Insurance plan, and coverage provided by a Multiple Employer Welfare Arrangement (MEWA) or employee self-insured plan except as exempt under federal ERISA provisions;
2.  “Homeopathic medicine” is a system of healing which utilizes generally accepted physical, pharmacological and homeopathic methods of diagnosis and therapy, including, but not limited to, the use of body mechanics, manipulative methods, and physiological therapeutics; and
3.  “Naturopathic medicine” means a system of natural health care that employs diagnosis and treatment using natural therapies and diagnostic techniques for the promotion, maintenance and restoration of health and the prevention of illness and disease including, but not limited to, eye health care, respiratory care, substance abuse treatment and sexual dysfunction.
C.  Any health benefit plan that is offered, issued or renewed in this state on or after January 1, 2010, that provides medical and surgical benefits shall provide coverage for alternative and complementary health care therapies including homeopathic and naturopathic medicine.
D.  The provisions of this section shall not apply to policies or certificates issued to groups with fifty (50) or fewer employees.
E.  1.  A health benefit plan that, at the end of its base period, experiences a greater than two percent (2%) increase in premium costs pursuant to providing benefits for alternative and complementary health care therapies shall be exempt from the provisions of subsection C of this section.
2.  To calculate the base period-premium costs, the health benefit plan shall subtract from premium costs incurred during the base period, both the premium costs incurred during the period immediately preceding the base period and any premium cost increases attributable to factors unrelated to benefits for alternative and complementary health care therapies.
3.	a.	To claim the exemption provided for in paragraph 1 of this subsection, a health benefit plan shall provide to the Insurance Commissioner a written request signed by an actuary stating the reasons and actuarial assumptions upon which the request is based.
b.	The Commissioner shall verify the information provided and shall approve or disapprove the request within thirty (30) days of receipt.
c.	If, upon investigation, the Commissioner finds that any statement of fact in the request is found to be knowingly false, the health benefit plan may be subject to suspension or loss of license or any other penalty as determined by the Commissioner.
F.  The Insurance Commissioner shall promulgate any rules necessary to implement the provisions of this section.
SECTION 2.  This act shall become effective November 1, 2009.

52-1-1583	ARE	1/14/2009 4:10:37 PM