HB 1122-2_ Filed 04/05/2001, 12:24

COMMITTEE REPORT




MR. PRESIDENT:

    The Senate Committee on Finance, to which was referred Engrossed House Bill No. 1122, has had the same under consideration and begs leave to report the same back to the Senate with the recommendation that said bill be AMENDED as follows:

SOURCE: Page 2, line 21; (01)AM112204.2. -->     Page 2, delete lines 21 through 31.
    Page 2, line 32, delete "(g)" and insert " (e)".
    Page 3, line 3, delete ":".
    Page 3, line 4, before "provides" delete "(1)".
    Page 3, run in lines 3 through 4.
    Page 3, line 5, delete "; and" and insert " .".
    Page 3, delete line 6.
    Page 3, line 30, after "policy" insert " that is issued on a group basis".
    Page 3, line 37, after "policy" delete "or".
    Page 3, line 38, delete "health plan".
    Page 3, delete lines 40 through 42.
    Page 4, delete lines 1 through 7.
    Page 4, line 8, delete "Sec. 5." and insert " (b)".
    Page 4, line 8, delete "chapter" and insert " section".
    Page 4, between lines 12 and 13, begin a new paragraph and insert:
    " Sec. 5. (a) An insurer that issues an accident and sickness insurance policy on an individual basis must offer to provide coverage for the treatment of a pervasive developmental disorder of an insured. Coverage provided under this section is limited to treatment that is prescribed by the insured's treating physician in accordance with a treatment plan. An insurer may not deny or refuse to issue coverage on, refuse to contract with, or refuse to renew, refuse to reissue, or otherwise terminate or restrict coverage on an individual under an insurance policy solely because the individual is diagnosed with a pervasive developmental

disorder.
    (b) The coverage that must be offered under this section may not be subject to dollar limits, deductibles, or coinsurance provisions that are less favorable to an insured than the dollar limits, deductibles, or coinsurance provisions that apply to physical illness generally under the accident and sickness insurance policy.
".
    Page 4, line 23, delete "section" and insert " subsection".
    Page 4, line 28, after "restrict" insert " coverage under a group contract to".
    Page 4, line 28, delete "to," and insert " to".
    Page 4, delete lines 30 through 38.
    Page 4, line 39, delete "(e)" and insert " (c)".
    Page 4, line 39, delete "this section" and insert " subsection (b)".
    Page 5, between lines 2 and 3, begin a new paragraph and insert:
    " (d) A health maintenance organization that enters into an individual contract that provides basic health care services must offer to provide services for the treatment of a pervasive developmental disorder of an enrollee. Services provided to an enrollee under this subsection are limited to services that are prescribed by the enrollee's treating physician in accordance with a treatment plan. A health maintenance organization may not deny or refuse to provide services to, or refuse to renew, refuse to reissue, or otherwise terminate or restrict coverage under an individual contract to services to an individual solely because the individual is diagnosed with a pervasive developmental disorder.
    (e) The services that must be offered under subsection (d) may not be subject to dollar limits, deductibles, copayments, or coinsurance provisions that are less favorable to an enrollee than


the dollar limits, deductibles, copayments, or coinsurance provisions that apply to physical illness generally under the contract with the health maintenance organization.".
    (Reference is to EHB 1122 as printed March 30, 2001.)

and when so amended that said bill do pass .

Committee Vote: Yeas 12, Nays 3.

____________________________________

Senator Borst, Chairperson


AM 112204/DI 101    2001