SENATE
HOUSE
JOINT
BILL STATUS
STATE LAW
REPORTS
EDUCATIONAL
CONTACT
home
home
SB483 SUB1 Senate Bill 483 History

OTHER VERSIONS  -  Introduced Version  |  Enrolled Version - Final Version (2)  |  Enrolled Version - Final Version  |     |  Email
Key: Green = existing Code. Red = new code to be enacted
COMMITTEE SUBSTITUTE

FOR


Senate Bill No. 483

(By Senators Minard and Chafin)

____________

[Originating in the Committee on Health and Human Resources;

reported February 17, 2010.]

____________


A BILL to amend and reenact §33-25A-5 of the Code of West Virginia, 1931, as amended, relating to health maintenance organizations; authority to provide a point of service option; and authority for the Office of the Insurance Commissioner to develop standards for a point of service option by legislative and emergency rule.

Be it enacted by the Legislature of West Virginia:
That §33-25A-5 of the Code of West Virginia, 1931, as amended, be amended and reenacted to read as follows:
ARTICLE 25A. HEALTH MAINTENANCE ORGANIZATION ACT.
§33-25A-5. Powers of health maintenance organizations.
(a) Upon obtaining a certificate of authority as required under this article, a health maintenance organization may enter into health maintenance contracts in this state and engage in any activities, consistent with the purposes and provisions of this article, which are necessary to the performance of its obligations under such contracts, subject to the limitations provided for in this article. A health maintenance organization may offer to its enrollees in conjunction with the benefits provided to them through their contractual arrangement for health services with the health maintenance organization a point of service option to be provided either by the health maintenance organization directly or by an insurance carrier licensed in this state with which the health maintenance organization has a contractual arrangement. Benefits for health care services within the health maintenance organization's contracted provider panel shall comply with all other provisions of this article. The commissioner may promulgate rules and regulations limiting or regulating the powers of health maintenance organizations which he finds to be in the public interest.
(b) For purposes of this article, "point of service option" means a delivery system that permits an enrollee to receive services, outside the panel of providers with which the health maintenance organization has a contractual arrangement, under the terms and conditions of the enrollee's contract with the health maintenance organization or the insurance carrier that provides the point of service option.
(c) The commissioner shall propose rules for legislative approval in accordance with the provisions of article three, chapter twenty-nine-a of this code limiting or regulating the powers of health maintenance organizations which the commissioner finds to be in the public interest. The commissioner shall promulgate emergency rules pursuant to the provisions of section fifteen, article three, chapter twenty-nine-a of this code to implement standards and requirements for a point of service option.
________


(NOTE: The purpose of this bill is to authorize HMO's to offer a point of service option.

Strike-throughs indicate language that would be stricken from the present law, and underscoring indicates new language that would be added.)

________


BANKING AND INSURANCE COMMITTEE AMENDMENT


By striking out the title and substituting therefor a new title, to read as follows:
Eng. Com. Sub. Senate Bill No. 483--A Bill to amend and reenact §33-25A-5 of the Code of West Virginia, 1931, as amended, relating to authorizing health maintenance organizations to provide a point of service option; providing a definition for "point of service option"; and authorizing the Office of the Insurance Commissioner to develop standards for a point of service option by legislative and emergency rule.


This Web site is maintained by the West Virginia Legislature's Office of Reference & Information.  |  Terms of Use  |   Email WebmasterWebmaster   |   © 2024 West Virginia Legislature **


X

Print On Demand

Name:
Email:
Phone:

Print