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H0522...........................................................by BUSINESS
HEALTH INSURANCE - Adds to existing law relating to health insurance
contracts to prohibit the assignment of a health insurance contract unless
disclosed to and agreed to by a health care practitioner or facility.
02/12 House intro - 1st rdg - to printing
02/13 Rpt prt - to Bus
02/20 Rpt out - rec d/p - to 2nd rdg
02/21 2nd rdg - to 3rd rdg
02/22 3rd rdg - PASSED - 63-0-7
AYES -- Anderson, Barrett, Bayer, Bell, Bilbao, Black, Block, Bock,
Boe, Bolz, Bowers, Brackett, Bradford, Chadderdon, Chavez, Chew,
Clark, Collins, Crane, Durst, Eskridge, Hagedorn, Hart, Harwood,
Henbest, Henderson, Jaquet, Killen, King, Labrador, Lake, LeFavour,
Loertscher, Luker, Marriott, Mathews, McGeachin, Mortimer, Moyle,
Nielsen, Nonini, Pasley-Stuart, Patrick, Pence, Ringo, Roberts,
Ruchti, Rusche, Sayler, Schaefer, Shepherd(02), Shepherd(08),
Shirley, Shively, Smith(30)(Stanek), Snodgrass, Thayn, Thomas, Trail,
Vander Woude, Wills, Wood(35), Mr. Speaker
NAYS -- None
Absent and excused -- Andrus, Bedke, Kren, Raybould, Smith(24),
Stevenson, Wood(27)
Floor Sponsor - Crane
Title apvd - to Senate
02/25 Senate intro - 1st rdg - to Com/HuRes
02/29 Rpt out - rec d/p - to 2nd rdg
03/03 2nd rdg - to 3rd rdg
03/06 3rd rdg - PASSED - 34-0-1
AYES -- Andreason, Bair, Bastian, Bilyeu, Broadsword, Burkett,
Cameron, Coiner, Corder, Darrington, Fulcher, Gannon, Geddes, Goedde,
Hammond, Heinrich, Hill, Jorgenson, Kelly, Keough, Langhorst, Little,
Lodge, Malepeai(Sagness), McGee, McKague, McKenzie, Pearce,
Richardson, Schroeder, Siddoway, Stegner, Stennett, Werk
NAYS -- None
Absent and excused -- Davis
Floor Sponsor - Goedde
Title apvd - to House
03/07 To enrol
03/10 Rpt enrol - Sp signed
03/11 Pres signed - To Governor
03/17 Governor signed
Session Law Chapter 139
Effective: 07/01/08
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]] Fifty-ninth Legislature Second Regular Session - 2008IN THE HOUSE OF REPRESENTATIVES HOUSE BILL NO. 522 BY BUSINESS COMMITTEE 1 AN ACT 2 RELATING TO HEALTH INSURANCE CONTRACTS; AMENDING CHAPTER 18, TITLE 41, IDAHO 3 CODE, BY THE ADDITION OF A NEW SECTION 41-1847, IDAHO CODE, TO PROHIBIT 4 THE ASSIGNMENT OF A HEALTH INSURANCE CONTRACT UNLESS DISCLOSED TO AND 5 AGREED TO BY A HEALTH CARE PRACTITIONER OR FACILITY. 6 Be It Enacted by the Legislature of the State of Idaho: 7 SECTION 1. That Chapter 18, Title 41, Idaho Code, be, and the same is 8 hereby amended by the addition thereto of a NEW SECTION, to be known and des- 9 ignated as Section 41-1847, Idaho Code, and to read as follows: 10 41-1847. ASSIGNMENT OF HEALTH INSURANCE CONTRACTS. (1) No insurer, as 11 defined in section 41-5601, Idaho Code, shall assign the benefits of any con- 12 tract with a practitioner or facility, as defined in section 41-5601, Idaho 13 Code, that contains an agreement by the practitioner or facility to provide 14 services to a patient covered by the insurer at a fee which is discounted from 15 that practitioner's or facility's usual and customary fee, unless the contract 16 between the insurer and the practitioner or facility, in conspicuous and plain 17 language, specifically permits the contract to be assigned. 18 (2) An insurer shall send prompt written or electronic notice to the 19 practitioner or facility, in conformance with the notice provisions of the 20 contract between the insurer and the practitioner or facility, of each assign- 21 ment it makes that is permitted by subsection (1) of this section. The notice 22 shall identify the name and principal business address of each assignee. 23 (3) An assignment in violation of this section shall be void. The direc- 24 tor shall enforce the provisions of this section and shall review and, if 25 appropriate, investigate complaints received by the department related to non- 26 compliance with the provisions of this section. If the director determines an 27 insurer has violated the provisions of this section, the director may impose 28 an administrative fine not to exceed five thousand dollars ($5,000) based upon 29 an enforcement action. The director shall not suspend or revoke an insurer's 30 certificate of authority for violation of this section. This section shall not 31 create a private cause of action by or on behalf of a beneficiary or practi- 32 tioner or facility against an insurer.
STATEMENT OF PURPOSE
RS17888C1
This legislation would prevent the assignment of a preferred provider
organization (PPO) contract between an insurer and a practitioner
without the agreement of both parties. A PPO arrangement is an
arrangement in which a health care practitioner agrees to discount
normal fees in order to participate in an insurer’s network. This
legislation merely clarifies that such agreements may not be assigned
to third parties without the consent of both parties to the
agreement.
FISCAL NOTE
There is no fiscal impact to the general fund.
CONTACT
Name: Ken McClure
Phone: 388-1200
STATEMENT OF PURPOSE/FISCAL NOTE H 522