CCS SS SCS HS HCS HB 762 -- WOMEN'S HEALTH SERVICES

This bill contains provisions pertaining to women's health care
services and insurance.

WOMEN'S HEALTH SERVICES

The bill makes several changes in the law governing the
provision of preventive health care services for women.  In its
main provisions, the bill:

(1)  Requires health carriers that offer obstetrical/
gynecological coverage and pharmaceutical coverage to provide
direct access to an obstetrician or gynecologist of a woman's
choice within the provider network for covered services;

(2)  Requires health carriers to notify enrollees of covered
cancer screenings at regular intervals, consistent with American
Cancer Society guidelines, and specifies the method of
notification;

(3)  Requires coverage for the diagnosis, treatment, and
management of osteoporosis for individuals with a condition or
medical history in which bone mass measurement is medically
indicated.  Testing or treatment must give consideration to peer
review medical literature;

(4)  Requires health carriers that provide pharmaceutical
coverage to include coverage for contraceptives which excludes
drugs and devices that are intended to induce an abortion.
Coverage for prescriptive contraceptive drugs or devices is not
excluded if prescribed for other diagnosed medical conditions;

(5)  Exempts specified insurance policies from the provisions of
the bill;

(6)  Allows health carriers to issue a health benefit plan to
persons or entities which excludes coverage for contraceptives
if the exclusion is based on a person's or entity's moral,
ethical, or religious beliefs.  Health carriers owned and
operated by religious entities are exempt from the insurance
requirement for contraceptive coverage;

(7)  Requires nonexempt health carriers to allow enrollees to
purchase a health benefit plan which includes coverage for
contraceptives if the plan excludes coverage for contraceptives;
and

(8)  Requires health carriers to provide clear and conspicuous
notice in the enrollment form whether contraceptives are
included in the plan and that the individual has the right to
have them included or excluded from the plan.  Carriers are
prohibited from disclosing any individual's request for
inclusion or exclusion of contraceptive coverage.  Further, no
carrier or purchaser of a plan may discriminate against an
enrollee because of the enrollee's request regarding
contraceptive coverage.

MEDICAID COVERAGE FOR BREAST AND CERVICAL CANCER

Medicaid recipients are eligible for Medicaid coverage for
breast and cervical cancer.

During the eligibility determination, a recipient will be
eligible during a period of presumptive eligibility.  If all
eligibility requirements are met, the person will receive
Medicaid coverage.

INSURANCE COVERAGE FOR MASTECTOMIES

Current law requires health insurance carriers to provide
coverage for mastectomies, prosthetic devices, or reconstructive
surgery.  The bill prohibits a time limit from being imposed on
an individual for the receipt of a prosthetic device or
reconstructive surgery.

The bill also requires that if an individual changes insurer,
the new policy will be subject to and provide coverage
consistent with the federal Women's Health and Cancer Rights Act.

HOSPITAL WHISTLEBLOWER PROTECTIONS

The bill makes a technical correction to the statutes concerning
whistleblower protections for employees of hospitals and
ambulatory surgical centers.

Employees must be informed of their right to notify the
Department of Health of any information concerning alleged
violations of applicable federal or state laws or administrative
rules concerning patient care and safety or facility safety.

DEPARTMENT OF INSURANCE

The Department of Insurance is required to submit a copy of any
contract, written agreement, or approved letter of intent to the
Attorney General if the contract agreement or letter obligates
the state in excess of $100,000.

Within 10 days, the Attorney General is required to review and
approve or disapprove the contract, agreement, or letter of
intent based on its legal form and content in order to protect
the interests of the state.  If no response is provided by the
Attorney General as stated, the contract is approved.

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