Bill Text: VA HB1251 | 2017 | Regular Session | Introduced
Bill Title: Health insurance; assignment of benefits.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2016-12-01 - Left in Commerce and Labor [HB1251 Detail]
Download: Virginia-2017-HB1251-Introduced.html
Be it enacted by the General Assembly of Virginia:
1. That §§ 38.2-4214, 38.2-4319 and 38.2-4509 of the Code of Virginia is amended and reenacted, and that the Code of Virginia is amended by adding in Article 1 of Chapter 34 of Title 38.2 a section numbered 38.2-3407.13 as follows:
§38.2-3407.13. Refusal to accept assignments prohibited.
A. No insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis, no corporation providing individual or group accident and sickness subscription contracts, no health maintenance organization providing a health care plan for health care services, and no dental services plan offering or administering prepaid dental services shall refuse to accept or make reimbursement pursuant to a bona fide assignment of benefits made to a health care provider or hospital by an insured, subscriber or plan enrollee.
B. For the purpose of this section "assignment of benefits" means the transfer of health care coverage reimbursement benefits or other rights under an insurance policy, subscription contract or health care plan by an insured, subscriber or plan enrollee to a health care provider or hospital.
§38.2-4214. (Effective until January 1, 2016)
Application of certain provisions of law.
No provision of this title except this chapter and,
insofar as they are not inconsistent with this chapter, §§38.2-200, 38.2-203,
38.2-209 through 38.2-213, 38.2-218 through 38.2-225, 38.2-230, 38.2-232,
38.2-305, 38.2-316, 38.2-316.1, 38.2-322, 38.2-326, 38.2-400, 38.2-402 through
38.2-413, 38.2-500 through 38.2-515, 38.2-600 through 38.2-620, 38.2-700
through 38.2-705, 38.2-900 through 38.2-904, 38.2-1017, 38.2-1018, 38.2-1038,
38.2-1040 through 38.2-1044, Articles 1 (§38.2-1300 et seq.) and 2 (§38.2-1306.2
et seq.) of Chapter 13, §§38.2-1312, 38.2-1314, 38.2-1315.1, 38.2-1317 through
38.2-1328, 38.2-1334, 38.2-1340, 38.2-1400 through 38.2-1442, 38.2-1446,
38.2-1447, 38.2-1800 through 38.2-1836, 38.2-3400, 38.2-3401, 38.2-3404,
38.2-3405, 38.2-3405.1, 38.2-3406.1, 38.2-3406.2, 38.2-3407.1 through
38.2-3407.6:1, 38.2-3407.9 through 38.2-3407.18, 38.2-3409, 38.2-3411 through
38.2-3419.1, 38.2-3430.1 through 38.2-3454, 38.2-3501, 38.2-3502, subdivision
13 of §38.2-3503, subdivision 8 of §38.2-3504, §§38.2-3514.1, 38.2-3514.2,
§§38.2-3516 through 38.2-3520 as they apply to Medicare supplement policies,
§§38.2-3522.1 through 38.2-3523.4, 38.2-3525, 38.2-3540.1, 38.2-3541 through
38.2-3542, 38.2-3543.2, Article 5 (§38.2-3551 et seq.) of Chapter 35, Chapter
35.1 (§38.2-3556 et seq.), §§38.2-3600 through 38.2-3607, Chapter 52 (§
38.2-5200 et seq.), Chapter 55 (§38.2-5500 et seq.), and Chapter 58 (§
38.2-5800 et seq.) of this title shall apply to the operation of a plan.
§38.2-4214. (Effective January
1, 2016) Application of certain provisions of law.
No provision of this title except this chapter and, insofar as
they are not inconsistent with this chapter, §§38.2-200, 38.2-203, 38.2-209
38.2-210 through 38.2-213, 38.2-218
through 38.2-225, 38.2-230, 38.2-232, 38.2-305, 38.2-316, 38.2-316.1, 38.2-322,
38.2-326, 38.2-400, 38.2-402 through
38.2-413, 38.2-500 through 38.2-515, 38.2-600 through 38.2-620, 38.2-700
through 38.2-705, 38.2-900 through 38.2-904, 38.2-1017, 38.2-1018, 38.2-1038,
38.2-1040 through 38.2-1044, Articles 1 (§38.2-1300 et seq.) and 2 (§
38.2-1306.2 et seq.) of Chapter 13, §§38.2-1312, 38.2-1314, 38.2-1315.1,
38.2-1317 through 38.2-1328, 38.2-1334, 38.2-1340, 38.2-1400
through 38.2-1442 38.2-1444,
38.2-1446, 38.2-1447, 38.2-1800
through 38.2-1836, 38.2-3400, 38.2-3401, 38.2-3404, 38.2-3405, 38.2-3405.1, 38.2-3406.1,
38.2-3406.2, 38.2-3407.1 through 38.2-3407.6:1
38.2-3407.6, 38.2-3407.9 through 38.2-3407.19 38.2-3407.13,
38.2-3409, 38.2-3411 through 38.2-3419.1, 38.2-3430.1 through
38.2-3454 38.2-3437, 38.2-3501, 38.2-3502, subdivision
13 of §38.2-3503, subdivision 8 of §38.2-3504, §§38.2-3514.1,
38.2-3514.2, §§38.2-3516 through 38.2-3520 as they
apply to Medicare supplement policies, §§38.2-3522.1
through 38.2-3523.4, §§38.2-3525, 38.2-3540.1, 38.2-3541,
through 38.2-3542, 38.2-3543.2, Article
5 (§38.2-3551 et seq.) of Chapter 35, Chapter 35.1 (§38.2-3556 et seq.), §§38.2-3600
through 38.2-3607, Chapter 52 (§38.2-5200 et seq.)Chapter
53 (§38.2-5300 et seq.), Chapter
55 (§38.2-5500 et seq.), and Chapter 58 (§38.2-5800 et seq.) of
this title shall apply to the operation of a plan.
§38.2-4319. (Effective until January 1, 2016)
Statutory construction and relationship to other laws.
A. No provisions of this title except this chapter
and, insofar as they are not inconsistent with this chapter, §§38.2-100,
38.2-136, 38.2-200, 38.2-203, 38.2-209 through 38.2-213, 38.2-216, 38.2-218
through 38.2-225, 38.2-229, 38.2-232, 38.2-305, 38.2-316, 38.2-316.1, 38.2-322,
38.2-326, 38.2-400, 38.2-402 through 38.2-413, 38.2-500 through 38.2-515,
38.2-600 through 38.2-620, Chapter 9 (§38.2-900 et seq.), §§38.2-1016.1
through 38.2-1023, 38.2-1057, 38.2-1306.1, Article 2 (§38.2-1306.2 et seq.), §
38.2-1315.1, Articles 3.1 (§38.2-1316.1 et seq.), 4 (§38.2-1317 et seq.), 5
(§38.2-1322 et seq.), and 5.1 (§38.2-1334.3 et seq.) of Chapter 13, Articles
1 (§38.2-1400 et seq.), 2 (§38.2-1412 et seq.), and 4 (§38.2-1446 et seq.)
of Chapter 14, §§38.2-1800 through 38.2-1836, 38.2-3401, 38.2-3405,
38.2-3405.1, 38.2-3406.1, 38.2-3407.2 through 38.2-3407.6:1, 38.2-3407.9
through 38.2-3407.18, 38.2-3411, 38.2-3411.2, 38.2-3411.3, 38.2-3411.4,
38.2-3412.1, 38.2-3414.1, 38.2-3418.1 through 38.2-3418.17, 38.2-3419.1,
38.2-3430.1 through 38.2-3454, 38.2-3500, subdivision 13 of §38.2-3503,
subdivision 8 of §38.2-3504, §§38.2-3514.1, 38.2-3514.2, 38.2-3522.1 through
38.2-3523.4, 38.2-3525, 38.2-3540.1, 38.2-3540.2, 38.2-3541.2, 38.2-3542,
38.2-3543.2, Article 5 (§38.2-3551 et seq.) of Chapter 35, Chapter 35.1 (§
38.2-3556 et seq.), Chapter 52 (§38.2-5200 et seq.), Chapter 55 (§38.2-5500
et seq.), and Chapter 58 (§38.2-5800 et seq.) shall be applicable to any
health maintenance organization granted a license under this chapter. This
chapter shall not apply to an insurer or health services plan licensed and
regulated in conformance with the insurance laws or Chapter 42 (§38.2-4200 et
seq.) except with respect to the activities of its health maintenance organization.
B. For plans administered by the Department of
Medical Assistance Services that provide benefits pursuant to Title XIX or
Title XXI of the Social Security Act, as amended, no provisions of this title
except this chapter and, insofar as they are not inconsistent with this
chapter, §§38.2-100, 38.2-136, 38.2-200, 38.2-203, 38.2-209 through 38.2-213,
38.2-216, 38.2-218 through 38.2-225, 38.2-229, 38.2-232, 38.2-322, 38.2-400,
38.2-402 through 38.2-413, 38.2-500 through 38.2-515, 38.2-600 through 38.2-620,
Chapter 9 (§38.2-900 et seq.), §§38.2-1016.1 through 38.2-1023, 38.2-1057,
38.2-1306.1, Article 2 (§38.2-1306.2 et seq.), §38.2-1315.1, Articles 3.1 (§
38.2-1316.1 et seq.), 4 (§38.2-1317 et seq.), 5 (§38.2-1322 et seq.), and 5.1
(§38.2-1334.3 et seq.) of Chapter 13, Articles 1 (§38.2-1400 et seq.), 2 (§
38.2-1412 et seq.), and 4 (§38.2-1446 et seq.) of Chapter 14, §§38.2-3401,
38.2-3405, 38.2-3407.2 through 38.2-3407.5, 38.2-3407.6, 38.2-3407.6:1,
38.2-3407.9, 38.2-3407.9:01, and 38.2-3407.9:02, subdivisions F 1, F 2, and F 3
of §38.2-3407.10, §§38.2-3407.11, 38.2-3407.11:3, 38.2-3407.13,
38.2-3407.13:1, 38.2-3407.14, 38.2-3411.2, 38.2-3418.1, 38.2-3418.2,
38.2-3419.1, 38.2-3430.1 through 38.2-3437, 38.2-3500, subdivision 13 of §
38.2-3503, subdivision 8 of §38.2-3504, §§38.2-3514.1, 38.2-3514.2,
38.2-3522.1 through 38.2-3523.4, 38.2-3525, 38.2-3540.1, 38.2-3540.2,
38.2-3541.2, 38.2-3542, 38.2-3543.2, Chapter 52 (§38.2-5200 et seq.), Chapter
55 (§38.2-5500 et seq.), and Chapter 58 (§38.2-5800 et seq.) shall be
applicable to any health maintenance organization granted a license under this
chapter. This chapter shall not apply to an insurer or health services plan
licensed and regulated in conformance with the insurance laws or Chapter 42 (§
38.2-4200 et seq.) except with respect to the activities of its health
maintenance organization.
C. Solicitation of enrollees by a licensed health
maintenance organization or by its representatives shall not be construed to
violate any provisions of law relating to solicitation or advertising by health
professionals.
D. A licensed health maintenance organization shall
not be deemed to be engaged in the unlawful practice of medicine. All health
care providers associated with a health maintenance organization shall be
subject to all provisions of law.
E. Notwithstanding the definition of an eligible
employee as set forth in §38.2-3431, a health maintenance organization
providing health care plans pursuant to §38.2-3431 shall not be required to
offer coverage to or accept applications from an employee who does not reside
within the health maintenance organization's service area.
F. For purposes of applying this section,
"insurer" when used in a section cited in subsections A and B shall
be construed to mean and include "health maintenance organizations"
unless the section cited clearly applies to health maintenance organizations
without such construction.
§38.2-4319. (Effective January
1, 2016) Statutory construction and relationship to other laws.
A. No provisions of this title except this chapter and,
insofar as they are not inconsistent with this chapter, §§38.2-100, 38.2-136,
38.2-200, 38.2-203, 38.2-209 38.2-210
through 38.2-213, 38.2-216, 38.2-218
through 38.2-225, 38.2-229, 38.2-232, 38.2-305, 38.2-316, 38.2-316.1, 38.2-322,
38.2-326, 38.2-400, 38.2-402 through
38.2-413, 38.2-500 through 38.2-515, 38.2-600 through 38.2-620, Chapter 9 (§
38.2-900 et seq.) of this title, §§38.2-1016.1
through 38.2-1023, 38.2-1057, 38.2-1306.138.2-1306.2
through 38.2-1309, Article 2 (§
38.2-1306.2 et seq.), §38.2-1315.1, Articles 3.1 (§38.2-1316.1
et seq.), 4 (§38.2-1317 et seq.),
and 5 (§38.2-1322 et seq.), and 5.1 (§
38.2-1334.3 et seq.) of Chapter 13, Articles 1 (§38.2-1400 et
seq.), and 2
(§38.2-1412 et seq.), and 4 (§38.2-1446 et seq) of
Chapter 14, §§38.2-1800 through 38.2-1836, 38.2-3401, 38.2-3405, 38.2-3405.1, 38.2-3406.1,
38.2-3407.2 through 38.2-3407.6:1 38.2-3407.6,
38.2-3407.9 through 38.2-3407.19 38.2-3407.13,
38.2-3411, 38.2-3411.2, 38.2-3411.3,
38.2-3411.4, 38.2-3412.1, 38.2-3414.1, 38.2-3418.1 through
38.2-3418.17 38.2-3418.7, 38.2-3419.1, 38.2-3430.1
through 38.2-3454 38.2-3437,
38.2-3500, subdivision 13 of §38.2-3503, subdivision 8 of §
38.2-3504, §§38.2-3514.1, 38.2-3514.2, 38.2-3522.1 through
38.2-3523.4, 38.2-3525, 38.2-3540.1, 38.2-3540.2, 38.2-3541.2, 38.2-3542,
38.2-3543.2, Article 5 (§38.2-3551 et seq.) of Chapter 35,
Chapter 35.1 (§38.2-3556 et seq.), Chapter 52 (§38.2-5200 et seq.)Chapter
53 (§38.2-5300 et seq.), Chapter 55 (§
38.2-5500 et seq.), and Chapter 58 (§38.2-5800 et seq.) of
this title shall be applicable to any health maintenance
organization granted a license under this chapter. This chapter shall not apply
to an insurer or health services plan licensed and regulated in conformance
with the insurance laws or Chapter 42 (§38.2-4200 et seq.) of this title except
with respect to the activities of its health maintenance organization.
B. For plans administered by the Department of
Medical Assistance Services that provide benefits pursuant to Title XIX or
Title XXI of the Social Security Act, as amended, no provisions of this title
except this chapter and, insofar as they are not inconsistent with this
chapter, §§38.2-100, 38.2-136, 38.2-200, 38.2-203, 38.2-209 through 38.2-213,
38.2-216, 38.2-218 through 38.2-225, 38.2-229, 38.2-232, 38.2-322, 38.2-400,
38.2-402 through 38.2-413, 38.2-500 through 38.2-515, 38.2-600 through
38.2-620, Chapter 9 (§38.2-900 et seq.), §§38.2-1016.1 through 38.2-1023,
38.2-1057, 38.2-1306.1, Article 2 (§38.2-1306.2 et seq.), §38.2-1315.1,
Articles 3.1 (§38.2-1316.1 et seq.), 4 (§38.2-1317 et seq.), 5 (§38.2-1322
et seq.), and 5.1 (§38.2-1334.3 et seq.) of Chapter 13, Articles 1 (§
38.2-1400 et seq.), 2 (§38.2-1412 et seq.), and 4 (§38.2-1446 et seq.) of
Chapter 14, §§38.2-3401, 38.2-3405, 38.2-3407.2 through 38.2-3407.5,
38.2-3407.6, 38.2-3407.6:1, 38.2-3407.9, 38.2-3407.9:01, and 38.2-3407.9:02,
subdivisions F 1, F 2, and F 3 of §38.2-3407.10, §§38.2-3407.11,
38.2-3407.11:3, 38.2-3407.13, 38.2-3407.13:1, 38.2-3407.14, 38.2-3411.2,
38.2-3418.1, 38.2-3418.2, 38.2-3419.1, 38.2-3430.1 through 38.2-3437,
38.2-3500, subdivision 13 of §38.2-3503, subdivision 8 of §38.2-3504, §§
38.2-3514.1, 38.2-3514.2, 38.2-3522.1 through 38.2-3523.4, 38.2-3525,
38.2-3540.1, 38.2-3540.2, 38.2-3541.2, 38.2-3542, 38.2-3543.2, Chapter 52 (§
38.2-5200 et seq.), Chapter 55 (§38.2-5500 et seq.), and Chapter 58 (§
38.2-5800 et seq.) shall be applicable to any health maintenance organization
granted a license under this chapter. This chapter shall not apply to an
insurer or health services plan licensed and regulated in conformance with the
insurance laws or Chapter 42 (§38.2-4200 et seq.) except with respect to the
activities of its health maintenance organization.
C. B. Solicitation
of enrollees by a licensed health maintenance organization or by its
representatives shall not be construed to violate any provisions of law
relating to solicitation or advertising by health professionals.
D. C. A
licensed health maintenance organization shall not be deemed to be engaged in
the unlawful practice of medicine. All health care providers associated with a
health maintenance organization shall be subject to all provisions of law.
E. D. Notwithstanding
the definition of an eligible employee as set forth in §38.2-3431, a health
maintenance organization providing health care plans pursuant to §38.2-3431
shall not be required to offer coverage to or accept applications from an
employee who does not reside within the health maintenance organization's
service area.
F. For purposes of applying this section,
"insurer" when used in a section cited in subsections A and B shall
be construed to mean and include "health maintenance organizations"
unless the section cited clearly applies to health maintenance organizations
without such construction.
§38.2-4509. (Effective until January 1, 2016)
Application of certain laws.
A. No provision of this title except this chapter
and, insofar as they are not inconsistent with this chapter, §§38.2-200,
38.2-203, 38.2-209 through 38.2-213, 38.2-218 through 38.2-225, 38.2-229,
38.2-316, 38.2-326, 38.2-400, 38.2-402 through 38.2-413, 38.2-500 through
38.2-515, 38.2-600 through 38.2-620, 38.2-900 through 38.2-904, 38.2-1038,
38.2-1040 through 38.2-1044, Articles 1 (§38.2-1300 et seq.) and 2 (§
38.2-1306.2 et seq.) of Chapter 13, §§38.2-1312, 38.2-1314, 38.2-1315.1,
Articles 4 (§38.2-1317 et seq.), 5 (§38.2-1322 et seq.), and 6 (§38.2-1335
et seq.) of Chapter 13, §§38.2-1400 through 38.2-1442, 38.2-1446, 38.2-1447,
38.2-1800 through 38.2-1836, 38.2-3401, 38.2-3404, 38.2-3405, 38.2-3407.1,
38.2-3407.4, 38.2-3407.10, 38.2-3407.13, 38.2-3407.14, 38.2-3407.15,
38.2-3407.17, 38.2-3415, 38.2-3541, Article 5 (§38.2-3551 et seq.) of Chapter
35, §§38.2-3600 through 38.2-3603, Chapter 55 (§38.2-5500 et seq.), and
Chapter 58 (§38.2-5800 et seq.) shall apply to the operation of a plan.
B. The provisions of subsection A of §38.2-322
shall apply to an optometric services plan. The provisions of subsection C of §
38.2-322 shall apply to a dental services plan.
C. The provisions of Article 1.2 (§32.1-137.7 et
seq.) of Chapter 5 of Title 32.1 shall not apply to either an optometric or
dental services plan.
D. The provisions of §38.2-3407.1 shall apply to
claim payments made on or after January 1, 2014 No optometric or dental
services plan shall be required to pay interest computed under §38.2-3407.1 if
the total interest is less than $5.
§38.2-4509. (Effective January
1, 2016) Application of certain laws.
A. No provision of this title except this chapter and, insofar
as they are not inconsistent with this chapter, §§38.2-200, 38.2-203, 38.2-209
38.2-210 through 38.2-213, 38.2-218
through 38.2-225, 38.2-229, 38.2-316, 38.2-326, 38.2-400,
38.2-402 through 38.2-413, 38.2-500 through 38.2-515, 38.2-600 through
38.2-620, 38.2-900 through 38.2-904, 38.2-1038, 38.2-1040 through 38.2-1044,
Articles 1 (§38.2-1300 et seq.) and 2 (§38.2-1306.2 et seq.) of Chapter 13, §§
38.2-1312, 38.2-1314, 38.2-1315.1, Articles
4 (§38.2-1317 et seq.), 5 (§38.2-1322 et seq.), and 6 (§38.2-1335 et
seq.) of Chapter 13, §§38.2-1400
through 38.2-144238.2-1444,
38.2-1446, 38.2-1447, 38.2-1800
through 38.2-1836, 38.2-3401, 38.2-3404, 38.2-3405, 38.2-3407.1,
38.2-3407.4, 38.2-3407.10, 38.2-3407.13, 38.2-3407.14,
38.2-3407.15, 38.2-3407.17, 38.2-3407.19, 38.2-3415, 38.2-3541, Article
5 (§38.2-3551 et seq.) of Chapter 35, §§38.2-3600 through 38.2-3603,
Chapter 55 (§38.2-5500 et seq.), and
Chapter 58 (§38.2-5800 et seq.) shall apply to the operation of a plan.
B. The provisions of subsection A of §38.2-322 shall apply to an optometric services plan. The provisions of subsection C of §38.2-322 shall apply to a dental services plan.
C. The provisions of Article 1.2 (§32.1-137.7 et seq.) of Chapter 5 of Title 32.1 shall not apply to either an optometric or dental services plan.
D. The provisions of §38.2-3407.1 shall apply to
claim payments made on or after January 1, 2014 No optometric or dental
services plan shall be required to pay interest computed under §38.2-3407.1 if
the total interest is less than $5.
