Introduced Version
Senate Bill 572 History
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Key: Green = existing Code. Red = new code to be enacted
Senate Bill No. 572
(By Senators Prezioso, Stollings, Foster and McCabe)
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[Introduced February 12, 2010; referred to the Committee on
Health and Human Resources; and then to the Committee on
Finance.]
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A BILL to amend and reenact §5-16B-6d of the Code of West Virginia,
1931, as amended, relating to granting authority to the board
of the Children's Health Insurance Program to establish
eligibility criteria for coverage for children who previously
had insurance under an employer-sponsored plan.
Be it enacted by the Legislature of West Virginia:
That §5-16B-6d of the Code of West Virginia, 1931, as amended,
be amended and reenacted to read as follows:
ARTICLE 16B. WEST VIRGINIA CHILDREN'S HEALTH INSURANCE PROGRAM.
§5-16B-6d. Modified benefit plan implementation.
(a) Upon approval by the Centers for Medicare and Medicaid
Services, the board shall implement a program for uninsured
children of families with income between two hundred and three
hundred percent of the federal poverty level.
(b) The benefit plans offered pursuant to this section shall
include services determined to be appropriate for children, but may
vary from those currently offered by the board.
(c) The board shall structure the benefit plans for this
expansion to include premiums, coinsurance or copays and
deductibles. The board shall develop the cost sharing features in
such a manner as to keep the program fiscally stable without
creating a barrier to enrollment. Such The features may include
different cost-sharing features within this group based upon the
percentage of the federal poverty level.
(d) Children covered by an employer sponsored health insurance
plan during the previous twelve month period are not
The board
shall establish a period that children must be uninsured prior to
being
eligible for coverage under this expansion, unless that
coverage is lost due to the parent's loss of employment.
(e) Provider reimbursement schedules shall may be no lower
than the reimbursement provided for the same services under the
plans offered in article sixteen of this chapter.
(f) All provisions of this article are applicable to this
expansion unless expressly addressed in this section.
(g) Nothing in this section may be construed to require
requires any appropriation of State General Revenue Funds for the
payment of any benefit provided pursuant to this section, except
for the state appropriation used to match the federal financial
participation funds. In the event that federal funds are no longer authorized for participation by individuals eligible at income
levels above two hundred percent, the board shall take immediate
steps to terminate the expansion provided for in this section and
notify all enrollees of such the termination. In the event federal
appropriations decrease for the programs created pursuant to Title
XXI of the Social Security Act of 1997, the board is directed to
make those decreases in this expansion program before making
changes to the programs created for those children whose family
income is less than two hundred percent of the federal poverty
level.
(h) The board is directed to report no less than quarterly to
the Legislative Oversight Commission on Health and Human Resources
Accountability on the development, implementation and progress of
the expansion authorized in this section.
NOTE: The purpose of this bill is to
give latitude to the
board of the Children's Health Insurance Program in setting
eligibility criteria for all children, including those that have
had coverage under an employer sponsored plan within the previous
twelve-month period.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.
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