H. B. 3113
(By Delegates Perdue, Fleischauer,
Hatfield, Brown, Amores, Manchin, Palumbo,
Canterbury, Hutchins, Browning and Boggs)
[Introduced February 16, 2007; referred to the
Committee on Finance.]
A BILL to amend the Code of West Virginia, 1931, as amended, by
adding thereto a new article, designated §5-1F-1, §5-1F-2,
§5-1F-3, §5-1F-4 and §5-1F-5, all relating to the Medical Cost
Containment Act; creating the Governor's Health Care
Partnership Council; prescribing duties for the Council;
providing for the review of new technologies; and providing
for advanced directives of living wills, medical powers of
attorney and combined medical powers of attorney and living
wills.
Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended
by adding thereto a new article, designated §5-1F-1, §5-1F-2,
§5-1F-3, §5-1F-4 and §5-1F-5, all to read as follows:
ARTICLE 1F. MEDICAL COST CONTAINMENT ACT.
§5-1F-1. The Governor's Health Care Partnership Council Created.
There is hereby created the Governor's Health Care Partnership Council. The Governor, or his or her designee, shall chair the
Council. The Council shall also be comprised of the Director of
the Public Employees Insurance Agency, the Director of Medical
Services within the Department of Health and Human Resources, the
Director of the Children's Health Insurance Program, the Chief
Executive Officers or their designee of Mountain State Blue Cross
Blue Shield, the Health Plan of the Upper Ohio Valley, and
Carelink. Other insurance carriers licensed to do business in West
Virginia may petition the Council for membership to the Council,
which upon the majority vote of the members of the Council
additional insurance carriers will be granted full membership in
the Council.
§5-1F-2. Duties of the Council.
The Council shall determine ways to reduce costs in the
provision of health care in the state. The Council may employ all
such consultants, actuaries and other experts as it deems
necessary. The Council shall complete its report and submit
recommendations to the Legislative Oversight Commission on Health
and Human Resources Accountability by no later than the first day
of December, two thousand seven and by the first day of December of
each year thereafter. Such report shall include among other things
its recommendations as to the statutory and administrative changes
necessary to ensure that quality health care will be delivered to
the citizens of the state as economically and efficiently as practicable.
The Council's duties shall include, but shall not be limited
to, exploring the funding of new and proven more efficient and
cost-saving procedures available to provide health care, such as
electronic prescriptions, the maintenance of medical records using
secure electronic media, a common disease management or care
management system, the use of a statewide nurse "hotline" to enable
all residents of the state to obtain medical advice by telephone,
common claims forms and procedures for health care providers to
submit claims to public and private insurers and other joint
programs that will improve the delivery of health care in West
Virginia.
§5-1F-3. Health Care Budget Process.
The Health Care Authority (hereafter authority) shall
establish by the first day of December, two thousand seven and by
the first day of December of each year, thereafter a projected
annual budget for the ensuing calendar year, which shall include
the total amount to be spent for health care in the state, and as
separate items, the amount to be spent in each sector of health
care, e.g., inpatient and outpatient treatment, pharmaceuticals,
professional services, durable medical equipment, and other
categories as established by the authority and the Council. By no
later than the fifteenth day of January, two thousand eight and by
the fifteenth day of January of each year thereafter, the authority shall compile the total amount actually spent in West Virginia in
the preceding calendar year and shall compare these amounts with
the respective budgeted amounts for such calendar year. In
compiling either the projected annual expenditures or the actual
annual expenditures the authority may request the aggregate claims
projection or the aggregate claims experience of the public and
private payers of health care that are members of the Council. The
public payers on the Council shall provide the authority any
aggregate data requested by the authority. The private payers on
the Council may, in their own discretion, provide the authority
with aggregate data requested by the authority. If the total
budget or any category of the budget exceeds the budgeted amount,
the authority shall make recommendations to the Governor and the
Legislature on ways in which these items may be better controlled
in the future.
§5-1F-4. Technology.
The authority shall collaborate with the state of Oregon
and/or other states it may designate in establishing a process for
the independent review of the cost effectiveness of such new
technology and procedures. The review of new technologies or
procedures shall include determining the populations most likely to
benefit from the new technologies or procedures and may recommend
that the new technologies and procedures are inappropriate for
certain populations. The authority shall report to the Legislative Oversight Commission on Health and Human Resources Accountability
by no later than the first day of December, two thousand seven and
the first day of December of each year thereafter as to its
findings and recommendations.
§5-1F-5. Advanced directives.
Prior to the first day of May, two thousand seven and every
year thereafter, the Public Employees Insurance Agency shall
distribute to all employees and retirees covered by the Public
Employees Insurance Agency a copy of advance directives of living
wills and medical powers of attorney and combined medical powers of
attorney and living wills as provided in section four, article
thirty, chapter sixteen of this code. The Public Employees
Insurance Agency may use the combined form provided in section
four, article thirty, chapter sixteen of this code. The PEIA
Finance Board may reduce copayments, coinsurance or monthly
premiums for employees or retirees who complete an advance
directive.
NOTE: The purpose of this bill is to provide for the Medical
Cost Containment Act. Toward this end, the bill creates the
Governor's Health Care Partnership Council, prescribes duties for
the Council and provides for the review of new medical
technologies. The bill also provides for advanced directives of
living wills, medical powers of attorney and combined medical
powers of attorney and living wills.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.