Senate Bill No. 206
(By Senator Fanning)
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[Introduced January 15, 2002; referred to the Committee
on Banking and Insurance; and then to the Committee on
Finance.]
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A BILL to amend and reenact section seven, article sixteen,
chapter five of the code of West Virginia, one thousand
nine hundred thirty-one, as amended; to amend article
fifteen, chapter thirty-three of said code by adding
thereto a new section, designated section four-g; to amend
article sixteen of said chapter by adding thereto a new
section, designated section three-p; to amend article
twenty-four of said chapter by adding thereto a new
section, designated section seven-g; to amend article
twenty-five of said chapter by adding thereto a new
section, designated section eight-f; and to amend article
twenty-five-a of said chapter by adding thereto a new
section, designated section eight-f, all relating to requiring health insurance policies to cover acupuncture
treatment.
Be it enacted by the Legislature of West Virginia:
That section seven, article sixteen, chapter five of the
code of West Virginia, one thousand nine hundred thirty-one, as
amended, be amended and reenacted; that article fifteen, chapter
thirty-three of said code be amended by adding thereto a new
section, designated section four-g; that article sixteen of said
chapter be amended by adding thereto a new section, designated
section three-p; that article twenty-four of said chapter be
amended by adding thereto a new section, designated section
seven-g; that article twenty-five of said chapter be amended by
adding thereto a new section, designated section eight-f; and
that article twenty-five-a of said chapter be amended by adding
thereto a new section, designated section eight-f, all to read
as follows:
CHAPTER 5. GENERAL POWERS AND AUTHORITY OF THE GOVERNOR,
SECRETARY OF STATE AND ATTORNEY GENERAL; BOARD
OF PUBLIC WORKS; MISCELLANEOUS AGENCIES, COMMISSIONS,
OFFICES, PROGRAMS, ETC.
ARTICLE 16. WEST VIRGINIA PUBLIC EMPLOYEES INSURANCE ACT.
§5-16-7. Authorization to establish group hospital and surgical
insurance plan, group major medical insurance plan, group prescription drug plan and group life and
accidental death insurance plan; rules for
administration of plans; mandated benefits; what
plans may provide; optional plans; separate rating
for claims experience purposes.
(a) The agency shall establish a group hospital and surgical
insurance plan or plans, a group prescription drug insurance
plan or plans, a group major medical insurance plan or plans and
a group life and accidental death insurance plan or plans for
those employees herein made eligible, and to establish and
promulgate rules for the administration of such plans, subject
to the limitations contained in this article. Those plans shall
include:
(1) Coverages and benefits for X ray and laboratory services
in connection with mammograms and pap smears when performed for
cancer screening or diagnostic services;
(2) Annual checkups for prostate cancer in men age fifty and
over;
(3) For plans that include maternity benefits, coverage for
inpatient care in a duly licensed health care facility for a
mother and her newly born infant for the length of time which
the attending physician deems considers medically necessary for
the mother or her newly born child: Provided, That no such plan may deny payment for a mother or her new born child prior to
forty-eight hours following a vaginal delivery, or prior to
ninety-six hours following a caesarean section delivery, if the
attending physician deems considers discharge medically
inappropriate; and
(4) For plans which provide coverages for post-delivery care
to a mother and her newly born child in the home, coverage for
inpatient care following childbirth as provided in subdivision
(3) of this subsection if such inpatient care is determined to
be medically necessary by the attending physician. Those plans
may also include, among other things, medicines, medical
equipment, prosthetic appliances and such other inpatient and
outpatient services and expenses deemed considered appropriate
and desirable by the agency; and
(5) Coverage and benefits for acupuncture treatment
performed by an acupuncturist licensed pursuant to article
thirty-six, chapter thirty of this code.
(b) The agency shall make available to each eligible
employee, at full cost to the employee, the opportunity to
purchase optional group life and accidental death insurance as
established under the rules of the agency. In addition, each
employee is entitled to have his or her spouse and dependents,
as defined by the rules of the agency, included in the optional coverage, at full cost to the employee, for each eligible
dependent; and with full authorization to the agency to make the
optional coverage available and provide an opportunity of
purchase to each employee.
(c) The finance board may cause to be separately rated for
claims experience purposes: (1) All employees of the state of
West Virginia; (2) all teaching and professional employees of
the university of West Virginia board of trustees or the board
of directors of the state college system and county boards of
education; (3) all nonteaching employees of the university of
West Virginia board of trustees or the board of directors of the
state college system and county boards of education; or (4) any
other categorization which would ensure the stability of the
overall program.
CHAPTER 33. INSURANCE.
ARTICLE 15. ACCIDENT AND SICKNESS INSURANCE.
§33-15-4g. Coverage for acupuncture treatment.
(a) Notwithstanding a provision of any policy, provision,
contract, plan or agreement to which this article applies, any
entity regulated by this article shall, on or after the first
day of July, two thousand two, provide as benefits to all
subscribers and members coverage for acupuncture treatment
performed by an acupuncturist licensed pursuant to article thirty-six, chapter thirty of this code.
(b) A policy, provision, contract, plan or agreement may
apply to acupuncture treatment the same deductibles, coinsurance
and other limitations as apply to other covered services.
ARTICLE 16. GROUP ACCIDENT AND SICKNESS INSURANCE.
§33-16-3p. Coverage for acupuncture treatment.
(a) Notwithstanding a provision of any policy, provision,
contract, plan or agreement to which this article applies, any
entity regulated by this article shall, on or after the first
day of July, two thousand two, provide as benefits to all
subscribers and members coverage for acupuncture treatment
performed by an acupuncturist licensed pursuant to article
thirty-six, chapter thirty of this code.
(b) A policy, provision, contract, plan or agreement may
apply to acupuncture treatment the same deductibles, coinsurance
and other limitations as apply to other covered services.
ARTICLE 24. HOSPITAL SERVICE CORPORATIONS, MEDICAL SERVICE
CORPORATIONS, DENTAL SERVICE CORPORATIONS AND
HEALTH SERVICE CORPORATIONS.
§33-24-7g. Coverage for acupuncture treatment.
(a) Notwithstanding a provision of any policy, provision,
contract, plan or agreement to which this article applies, any
entity regulated by this article shall, on or after the first day of July, two thousand two, provide as benefits to all
subscribers and members coverage for acupuncture treatment
performed by an acupuncturist licensed pursuant to article
thirty-six, chapter thirty of this code.
(b) A policy, provision, contract, plan or agreement may
apply to acupuncture treatment the same deductibles, coinsurance
and other limitations as apply to other covered services.
ARTICLE 25. HEALTH CARE CORPORATIONS.
§33-25-8f. Coverage for acupuncture treatment.
(a) Notwithstanding a provision of any policy, provision,
contract, plan or agreement to which this article applies, any
entity regulated by this article shall, on or after the first
day of July, two thousand two, provide as benefits to all
subscribers and members coverage for acupuncture treatment
performed by an acupuncturist licensed pursuant to article
thirty-six, chapter thirty of this code.
(b) A policy, provision, contract, plan or agreement may
apply to acupuncture treatment the same deductibles, coinsurance
and other limitations as apply to other covered services.
ARTICLE 25A. HEALTH MAINTENANCE ORGANIZATION ACT.
§33-25A-8f. Coverage for acupuncture treatment.
(a) Notwithstanding a provision of any policy, provision,
contract, plan or agreement to which this article applies, any entity regulated by this article shall, on or after the first
day of July, two thousand two, provide as benefits to all
subscribers and members coverage for acupuncture treatment
performed by an acupuncturist licensed pursuant to article
thirty-six, chapter thirty of this code.
(b) A policy, provision, contract, plan or agreement may
apply to acupuncture treatment the same deductibles, coinsurance
and other limitations as apply to other covered services.
NOTE: The purpose of this bill is to require health
insurance policies to cover acupuncture treatment.
Strike-throughs indicate language that would be stricken
from the present law, and underscoring indicates new language
that would be added.
§33-15-4g, §33-16-3p, §33-24-7g, §33-25-8f and §33-25A-8f
are new; therefore, strike-throughs and underscoring have been
omitted.
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