HCS HB 762 -- WOMEN'S HEALTH SERVICES

SPONSOR:  Barry

COMMITTEE ACTION:  Voted "do pass" by the Committee on Children,
Families and Health by a vote of 12 to 1 with 1 present.

This substitute requires each health carrier that offers or
issues benefit plans that provide obstetrical, gynecological,
and pharmaceutical coverage which is issued, continued, or
renewed in Missouri on or after January 1, 2002, to provide
enrollees with direct access to the services of a participating
obstetrician, gynecologist, or participating
obstetrician/gynecologist of her choice within the provider
network.  This requirement must be consistent with Subsection 4
of Section 354.618, RSMo, pertaining to open referrals for
covered obstetrical and gynecological care within a provider
network.  The services covered by this provision are limited to
services defined by published recommendations of the
Accreditation Council for Graduate Medical Education for
Training Obstetricians, Gynecologists and
Obstetricians/Gynecologists.

A health carrier is prohibited from imposing a surcharge or
additional co-payments or deductibles upon enrollees who seek
obstetrical or gynecological services covered by the substitute
unless similar charges are imposed for other types of health
care services received within the provider network.

Enrollees are required to be notified of cancer screenings at
intervals consistent with current American Cancer Society
guidelines.  The cancer screenings must be covered by the
enrollee's health benefit plans.

Health carriers are required to provide coverage for a one-time,
baseline bone density test for post-menopausal women as part of
their annual examination.

If a health benefit plan also provides coverage for
pharmaceutical benefits, the plan is required to provide
coverage for contraceptives either at no charge or at the same
level of deductible or co-payment as any other drug on the
health benefits plan's  formulary.  Coverage for contraceptives
include drugs, devices, or methods that prevent conception.

The provisions of the substitute do not apply to supplemental
insurance policies, life care contracts, accident only policies,
specified disease policies, Medicare supplement policies, or
long-term care policies.

The coverage for contraceptives does not require any person or
entity to provide contraceptive coverage if the coverage is
contrary to religious beliefs sincerely held by a person who
stands in a direct relationship with an entity.  Entities are
required to document sincerely held religious beliefs.

FISCAL NOTE:  Estimated Net Cost to All Funds of Unknown in FY
2002, FY 2003, and FY 2004.  Cost is expected to exceed $100,000
annually.  Estimated Net Cost to General Revenue Fund of Unknown
in FY 2002, FY 2003, and FY 2004.  Estimated Net Income to
Insurance Dedicated Fund of $10,000 in FY 2002, $0 in FY 2003,
and $0 in FY 2004.

PROPONENTS:  Supporters say that the primary purpose of the bill
is to improve the provision of health care and health care
access for women in Missouri.  Providing coverage for a bone
density screening is a preventive measure to detect an
abnormality before it progresses to osteoporosis.  The coverage
for contraceptives will provide women other health benefits
which include lowering the incidence of endometrial cancer,
cervical cancer, and pelvic inflammatory disease.  Additional
benefits include reducing the symptoms associated with
dysmenorrhea and endometriosis.  Supporters further state that
the notification requirement for cancer screenings is another
preventive measure for detecting various forms of cancers before
they spread to other tissues or organs, thus lowering the
mortality rate among women in Missouri.

Testifying for the bill were Representative Barry; Governor's
Office; Planned Parenthood of St. Louis; Siteman Cancer Center;
American Civil Liberties Union of Eastern Missouri; Service
Employees International Union; Robert Ferris, M.D.; and Missouri
Nurses Association.

OPPONENTS:  Those who oppose the bill say that the original
language did not clearly define contraceptives and lacked an
exception clause for religious entities who elect not to provide
contraceptive coverage.

Testifying against the bill were Campaign Life of Missouri;
Concerned Women for American, Missouri Chapter; Missouri
Catholic Conference; and B. Marie Ballard.

Joseph Deering, Legislative Analyst

Missouri House of Representatives
Last Updated November 26, 2001 at 11:45 am