HCS SCS SB 1061 & 1062 -- HEALTH INSURANCE

CO-SPONSORS:  Rohrbach, Kenney (Harlan)

COMMITTEE ACTION:  Voted "do pass" by the Committee on Critical
Issues, Consumer Protection and Housing by a vote of 20 to 0.

HEALTH SERVICES CORPORATION

The substitute increases the time for the Director of the
Department of Insurance to review health services corporation
policy forms from 30 days to 45 days.  If the director does not
disapprove the form within 45 days, the form is deemed approved
and is not subject to disapproval for 12 months.

If during the 12-month period the director determines that any
provision of the policy is contrary to state law, the director
must notify the carrier and may request that the carrier file an
amendment to modify the provision so that it conforms with state
law.  Upon approval of the amendment by the director, the carrier
must provide a copy of the amendment to the individuals or
entities to which the policies were issued.  This procedure is
also used when carriers file certain documents pertaining to
their certificate of authority with the department.

NETWORK ADEQUACY

The substitute requires the director to deem a managed care
plan's network to be adequate if the carrier files an affidavit
stating that the network is approved by the Federal Centers for
Medicare and Medicaid, the National Committee for Quality
Assurance, or the Joint Commission on the Accreditation of Health
Organizations.

INTERNET FORMS

The substitute allows any managed care entity to provide
documents and materials to an enrollee via the entity's Internet
site, instead of in printed form, upon securing a waiver from the
enrollee.  The enrollee may revoke the waiver at any time.

MENTAL HEALTH PARITY

The substitute requires health carriers that offer health benefit
plans in this state on or after January 1, 2003, to provide
coverage for mental health conditions.  Mental health conditions
are defined as those listed in the most recent edition of the
Diagnostic and Statistical Manual of Mental Disorders.  Coverage
for mental health conditions cannot have rates, terms, or
conditions that place a greater financial burden on an insured
for mental health treatment than for physical health treatment.
The substitute does not apply to supplemental insurance policies.

The substitute also repeals several sections relating to mental
illness and addictive disorders.  The sections repealed include
current exceptions to the requirement that health insurers who
cover services for mental illness and addictive disorders provide
the same coverage as they do for physical illness.  These include
exceptions that allow insurers to limit inpatient hospital
treatment for mental illness to 90 days per year (Section
376.811.2, RSMo); place annual and lifetime limits on alcohol and
drug abuse treatment services (Section 376.827); and exclude or
apply different limits to certain specified services (Section
376.833).

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of $0 to
less than $50,000 in FY 2003, FY 2004, and FY 2005.  Estimated
Net Income to Insurance Dedicated Fund of $9,850 in FY 2003, $0
in FY 2004, and $0 in FY 2005.

PROPONENTS:  Supporters say that the substitute is needed to
alleviate some of the rising costs of health insurance.  It would
provide some administrative relief for insurance companies and
could help foster competition by helping insurance companies get
plans to the market more quickly.

Testifying for the bill were Senator Rohrbach; Mid-America Health
of Kansas City; Missouri Association of Health Plans; United
Health Care; Blue Cross/Blue Shield of Missouri; and Coventry
Health Care of Kansas City.

OPPONENTS:  There was no opposition voiced to the committee.

Dana Estes, Legislative Analyst

Missouri House of Representatives
Last Updated October 11, 2002 at 9:04 am