2001 Legislation
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HOUSE BILL NO. 228 – Managed care, emergency services

HOUSE BILL NO. 228

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Daily Data Tracking History



H0228aa.........................................................by BUSINESS
MANAGED CARE - Amends existing law to provide that no managed care
organization shall require prior authorization for emergency services; to
provide for emergency services provided to a member who is unable to
reasonably reach a participating provider; to provide for medically
necessary covered services that are not reasonably available through
participating health care providers or are provided by a nonparticipating
provider; and to provide for reimbursement for services provided by a
nonparticipating provider.
                                                                        
02/14    House intro - 1st rdg - to printing
02/15    Rpt prt - to Bus
03/06    Rpt out - to Gen Ord
03/14    Rpt out amen - to engros
03/15    Rpt engros - 1st rdg - to 2nd rdg as amen
03/16    To Gen Ord
03/21    Ret'd to Bus

Bill Text


                                                                        
                                                                        
  ||||              LEGISLATURE OF THE STATE OF IDAHO             ||||
 Fifty-sixth Legislature                  First Regular Session - 2001
                                                                        
                                                                        
                              IN THE HOUSE OF REPRESENTATIVES
                                                                        
                                     HOUSE BILL NO. 228
                                                                        
                                   BY BUSINESS COMMITTEE
                                                                        
  1                                        AN ACT
  2    RELATING TO THE IDAHO MANAGED CARE REFORM ACT; AMENDING SECTION 41-3930, IDAHO
  3        CODE, TO PROVIDE THAT NO MANAGED CARE  ORGANIZATION  SHALL  REQUIRE  PRIOR
  4        AUTHORIZATION  FOR  EMERGENCY  SERVICES, TO PROVIDE FOR EMERGENCY SERVICES
  5        PROVIDED TO A MEMBER WHO IS UNABLE TO  REASONABLY  REACH  A  PARTICIPATING
  6        PROVIDER, TO PROVIDE FOR MEDICALLY NECESSARY COVERED SERVICES THAT ARE NOT
  7        REASONABLY  AVAILABLE  THROUGH  PARTICIPATING HEALTH CARE PROVIDERS OR ARE
  8        PROVIDED BY A NONPARTICIPATING PROVIDER, TO PROVIDE FOR REIMBURSEMENT  FOR
  9        SERVICES  PROVIDED  BY  A  NONPARTICIPATING PROVIDER AND TO PROVIDE PROCE-
 10        DURES; AND DECLARING AN EMERGENCY.
                                                                        
 11    Be It Enacted by the Legislature of the State of Idaho:
                                                                        
 12        SECTION 1.  That Section 41-3930, Idaho Code, be, and the same  is  hereby
 13    amended to read as follows:
                                                                        
 14        41-3930.  UTILIZATION  MANAGEMENT  PROGRAM  REQUIREMENTS.  (1) All managed
 15    care organizations performing utilization management or contracting with third
 16    parties for the performance of utilization management shall:
 17        (a)  Adopt utilization management criteria based on sound patient care and
 18        scientific principles developed in cooperation  with  licensed  physicians
 19        and  other  providers  as deemed appropriate by the managed care organiza-
 20        tion. Such criteria shall be sufficiently  flexible  to  allow  deviations
 21        from norms when justified on a case-by-case basis;
 22        (b)  Adopt  procedures  for  a timely review by a licensed physician, peer
 23        provider or peer review panel when a claim has been denied  as  not  medi-
 24        cally  necessary  or  as  experimental.  The procedure shall provide for a
 25        written statement of the reasons the service was denied and transmittal of
 26        that information to the appropriate provider for inclusion in the member's
 27        permanent medical record;
 28        (c)  Upon enrollment, require members to provide written authorization for
 29        the release of medical information to the managed care organization;
 30        (d)  Adopt procedures which protect the confidentiality of patient  health
 31        records.  Such procedures may permit a managed care organization to record
 32        a telephone conversation in  the  course  of  requesting  patient  medical
 33        information  only  if it complies with existing state and federal laws and
 34        the other party to the conversation is notified by voice message  that  he
 35        is  being  recorded.  Upon written request and within a reasonable time, a
 36        copy of such recordings shall be provided to the other party to  the  con-
 37        versation if the recorded conversation becomes an issue in a formal griev-
 38        ance  procedure,  and the other party agrees to reimburse the managed care
 39        organization for reasonable costs associated with providing the  requested
 40        copy.
 41        (2) (a)  If  emergency services are offered, nNo managed care organization
 42        shall require prior authorization for emergency services.  Emergency  ser-
 43        vices provided to a member who is unable to reasonably reach a participat-
                                                                        
                                           2
                                                                        
  1        ing  provider  shall be covered as if provided by a participating provider
  2        until the member can reasonably be expected to transfer to a participating
  3        provider.
  4        (b)  In addition, a A managed care organization shall respond to member or
  5        provider requests for prior authorization of a nonemergency service within
  6        two (2) business days after complete member medical information   is  pro-
  7        vided  to  the  managed care organization unless exceptional circumstances
  8        warrant a longer period to evaluate a request. Medically necessary covered
  9        services that are not reasonably available  through  participating  health
 10        care  providers  or are provided by a nonparticipating provider to provide
 11        continuity of care during brief transition periods shall be covered as  if
 12        provided  by  a  participating provider until the member can reasonably be
 13        expected to transfer to a participating provider. Qualified  medical  per-
 14        sonnel  shall  be  available  during  normal  business hours for telephone
 15        responses to inquiries about medical necessity, including certification of
 16        continued length of stay.
 17        (c)  Reimbursement for services provided by  a  nonparticipating  provider
 18        that are required to be covered as though provided by a participating pro-
 19        vider  shall  be based upon the usual, customary and reasonable charge for
 20        such services in the managed care organization's service area or  upon  an
 21        amount  agreed  to  by the provider and the managed care organization. The
 22        managed care organization may adopt procedures to allow for a timely noti-
 23        fication to a member or the member's representative for the transition  of
 24        medical care to participating providers following the stabilization of the
 25        presenting  medical condition and the availability of a qualified partici-
 26        pating provider.
 27        (3)  When prior approval for a covered service is required of and obtained
 28    by or on behalf of a member, the approval  shall  be  final  and  may  not  be
 29    rescinded  by the managed care organization after the covered service has been
 30    provided except in cases of fraud, misrepresentation, nonpayment  of  premium,
 31    exhaustion  of  benefits  or  if  the  member  for whom the prior approval was
 32    granted is not enrolled at the time the covered service was provided.
                                                                        
 33        SECTION 2.  An emergency existing  therefor,  which  emergency  is  hereby
 34    declared to exist, this act shall be in full force and effect on and after its
 35    passage and approval.

Amendment


                                                                        
                                                                        
  ||||              LEGISLATURE OF THE STATE OF IDAHO             ||||
 Fifty-sixth Legislature                  First Regular Session - 2001
                                                                        
                                                                        
                                                     Moved by    Deal                
                                                                        
                                                     Seconded by Henbest             
                                                                        
                                                                        
                              IN THE HOUSE OF REPRESENTATIVES
                              HOUSE AMENDMENT TO H.B. NO. 228
                                                                        
  1                               AMENDMENTS TO SECTION 1
  2        On page 1 of the printed bill, delete lines 42 and 43; on page  2,  delete
  3    lines  1  through  3, and insert: "shall require prior authorization for emer-
  4    gency services.  All medically necessary covered emergency  services  provided
  5    to  a  member who is unable to reasonably reach a participating provider shall
  6    be reimbursed by the managed care organization to the patient at a level as if
  7    the covered services were provided by a participating provider until the  mem-
  8    ber  can  reasonably  be  expected  to transfer to a participating provider.";
  9    delete lines 8 through 13, and insert: "warrant a longer period to evaluate  a
 10    request.  All medically necessary covered services that are provided by a non-
 11    participating provider to provide continuity of care during a brief transition
 12    period from emergency services shall be reimbursed by the managed care organi-
 13    zation to the patient at a level as if the covered service was provided  by  a
 14    participating provider until the member can reasonably be expected to transfer
 15    to  a  participating  provider.   Qualified medical per-"; and delete lines 17
 16    through 26.
                                                                        
 17                                 CORRECTIONS TO TITLE
 18        On page 1, in line 8, delete "," and insert: "AND"; in line 9, delete "AND
 19    TO PROVIDE PROCE-"; and in line 10, delete "DURES".

Engrossed Bill (Original Bill with Amendment(s) Incorporated)


                                                                        
                                                                        
  ||||              LEGISLATURE OF THE STATE OF IDAHO             ||||
 Fifty-sixth Legislature                  First Regular Session - 2001
                                                                        
                                                                        
                              IN THE HOUSE OF REPRESENTATIVES
                                                                        
                               HOUSE BILL NO. 228, As Amended
                                                                        
                                   BY BUSINESS COMMITTEE
                                                                        
  1                                        AN ACT
  2    RELATING TO THE IDAHO MANAGED CARE REFORM ACT; AMENDING SECTION 41-3930, IDAHO
  3        CODE, TO PROVIDE THAT NO MANAGED CARE  ORGANIZATION  SHALL  REQUIRE  PRIOR
  4        AUTHORIZATION  FOR  EMERGENCY  SERVICES, TO PROVIDE FOR EMERGENCY SERVICES
  5        PROVIDED TO A MEMBER WHO IS UNABLE TO  REASONABLY  REACH  A  PARTICIPATING
  6        PROVIDER, TO PROVIDE FOR MEDICALLY NECESSARY COVERED SERVICES THAT ARE NOT
  7        REASONABLY  AVAILABLE  THROUGH  PARTICIPATING HEALTH CARE PROVIDERS OR ARE
  8        PROVIDED BY A NONPARTICIPATING PROVIDER AND TO PROVIDE  FOR  REIMBURSEMENT
  9        FOR  SERVICES  PROVIDED  BY  A NONPARTICIPATING PROVIDER; AND DECLARING AN
 10        EMERGENCY.
                                                                        
 11    Be It Enacted by the Legislature of the State of Idaho:
                                                                        
 12        SECTION 1.  That Section 41-3930, Idaho Code, be, and the same  is  hereby
 13    amended to read as follows:
                                                                        
 14        41-3930.  UTILIZATION  MANAGEMENT  PROGRAM  REQUIREMENTS.  (1) All managed
 15    care organizations performing utilization management or contracting with third
 16    parties for the performance of utilization management shall:
 17        (a)  Adopt utilization management criteria based on sound patient care and
 18        scientific principles developed in cooperation  with  licensed  physicians
 19        and  other  providers  as deemed appropriate by the managed care organiza-
 20        tion. Such criteria shall be sufficiently  flexible  to  allow  deviations
 21        from norms when justified on a case-by-case basis;
 22        (b)  Adopt  procedures  for  a timely review by a licensed physician, peer
 23        provider or peer review panel when a claim has been denied  as  not  medi-
 24        cally  necessary  or  as  experimental.  The procedure shall provide for a
 25        written statement of the reasons the service was denied and transmittal of
 26        that information to the appropriate provider for inclusion in the member's
 27        permanent medical record;
 28        (c)  Upon enrollment, require members to provide written authorization for
 29        the release of medical information to the managed care organization;
 30        (d)  Adopt procedures which protect the confidentiality of patient  health
 31        records.  Such procedures may permit a managed care organization to record
 32        a telephone conversation in  the  course  of  requesting  patient  medical
 33        information  only  if it complies with existing state and federal laws and
 34        the other party to the conversation is notified by voice message  that  he
 35        is  being  recorded.  Upon written request and within a reasonable time, a
 36        copy of such recordings shall be provided to the other party to  the  con-
 37        versation if the recorded conversation becomes an issue in a formal griev-
 38        ance  procedure,  and the other party agrees to reimburse the managed care
 39        organization for reasonable costs associated with providing the  requested
 40        copy.
 41        (2) (a)  If  emergency services are offered, nNo managed care organization
 42        shall require prior authorization for emergency  services.  All  medically
 43        necessary covered emergency services provided to a member who is unable to
                                                                        
                                           2
                                                                        
  1        reasonably  reach a participating provider shall be reimbursed by the man-
  2        aged care organization to the patient at a level as if  the  covered  ser-
  3        vices  were provided by a participating provider until the member can rea-
  4        sonably be expected to transfer to a participating provider.
  5        (b)  In addition, a A managed care organization shall respond to member or
  6        provider requests for prior authorization of a nonemergency service within
  7        two (2) business days after complete member medical information   is  pro-
  8        vided  to  the  managed care organization unless exceptional circumstances
  9        warrant a longer period to evaluate a  request.  All  medically  necessary
 10        covered  services that are provided by a nonparticipating provider to pro-
 11        vide continuity of care during a brief transition  period  from  emergency
 12        services  shall  be  reimbursed  by  the  managed care organization to the
 13        patient at a level as if the covered service was provided by a participat-
 14        ing provider until the member can reasonably be expected to transfer to  a
 15        participating  provider.  Qualified  medical  personnel shall be available
 16        during normal business hours for telephone responses  to  inquiries  about
 17        medical necessity, including certification of continued length of stay.
 18        (3)  When prior approval for a covered service is required of and obtained
 19    by  or  on  behalf  of  a  member,  the approval shall be final and may not be
 20    rescinded by the managed care organization after the covered service has  been
 21    provided  except  in cases of fraud, misrepresentation, nonpayment of premium,
 22    exhaustion of benefits or if the  member  for  whom  the  prior  approval  was
 23    granted is not enrolled at the time the covered service was provided.
                                                                        
 24        SECTION  2.  An  emergency  existing  therefor,  which emergency is hereby
 25    declared to exist, this act shall be in full force and effect on and after its
 26    passage and approval.

Statement of Purpose / Fiscal Impact


                      STATEMENT OF PURPOSE
                                
                            RS 10914
                                
                                
The purpose of this legislation is to clarify the responsibilities
of managed care plans and their members with respect to emergency
health care services and health care services obtained from a
nonparticipating health care provider due to the unavailability of
a participating provider.  If a participating provider is not
reasonably available, the managed care organization will be
required to cover services rendered by a nonparticipating provider
as though a participating provider rendered the services.  If a
managed care organization is required to reimburse a
nonparticipating provider under this section, the reimbursement
obligation will be limited to the usual, customary, and reasonable
charge for such services in the managed care organization's service
area, or such other amount as agreed to between the managed care
organization and the provider.

                         FISCAL IMPACT
There will be no fiscal impact to the general fund.

     CONTACT:  Rep. W.W. "Bill" Deal
          (208) 332-1000
     


STATEMENT OF PURPOSE/FISCAL NOTE       H 228