- HB 165 (House Bill 165) – Health Reform – Administrative Simplification
- HB 178 (House Bill 178) – Health Insurance and Program Amendments
- HB 188 (House Bill 188) – Health System Reform – Insurance Market
- HB 331 (House Bill 331) – Health Insurance Coverage in State Contracts
Highlighted below are the three bills that will have largest impact on Utah residents. Click HB 331 to learn more about this bill.
House Bill 165 – Administration Simplification. This bill…
-Amends the timing of the requirement that a hospital sends an itemized bill to a patient.
-Creates a system-wide, broad based demonstration project between health care payers and health care providers for innovating the payment and delivery of health care in the state.
-Establishes a committee to study and develop a more efficient coordination of benefits process.
-Requires health benefit plans to issue to enrollees a printed card containing health plan information.
-Requires an insurer to provide access to information sufficient for a health care provider to determine the compensation or payment terms for health care services.
-Requires the Insurance Department to convene a group of providers and payers to establish standards for the electronic exchange of health plan information using card swipe technology which is compatible with national electronic standards.
-Prohibits an insurer from requiring less than one business day’s notice of an emergency in-patient hospital admission and amends the period of time in which an insurer can recover an amount paid to a health care provider when the insurer determines the payment was incorrect.
-Requires hospitals sending bills to patients to include the following words in bold “THIS IS THE BALANCE DUE AFTER PAYMENT FROM YOUR HEALTH INSURER,” or other appropriate language.
House Bill 178 – Health Insurance and Program Amendments. This bill…
-Clarifies that the Children’s Health Insurance Program should have access to at least two different provider networks.
-Extends the COBRA premium assistance provided under Section 3001 of the American Recovery and Reinvestment Act of 2009 (Pub. S. 111-5) to state mini-COBRA benefits; and
-Makes technical amendments to the health benefit plan broker disclosure
House Bill 188 – Health System Reform – Insurance Market. This bill…
-Prohibits balanced billing by certain health care providers in certain circumstances.
-Revises the basic benefit plan used for consumer comparison of health benefit products.
-Requires the Insurance Department to include in its annual market report a summary of the types of plans sold through the Internet portal, including market penetration of mandate lite products.
-Allows insurers to offer lower cost health insurance products that do not include certain state mandates in the individual market, the small employer group market, and in the conversion market;
-Creates the Utah NetCare Plan, a low cost health benefit plan as an alternative to current federal COBRA, state mini-COBRA, and conversion products.
-Requires health insurance brokers and producers to disclose their commissions and compensation to their customers prior to selling a health benefit plan.payment reform demonstration projects.
-Modifies the number and type of products an insurer must offer in the small employer group market and the individual market.
-Establishes a defined contribution arrangement market available on the Internet portal, which; 1. Beginning January 1, 2010, is available to small employer groups. 2. Offers a range of health benefit plan choices to an employer’s eligible employees. 3. Beginning January 1, 2012, is available to eligible large employer groups. 4. Beginning January 1, 2012, will offer a wider range of choices of health benefit plans to employees.
-Establishes a board within the Insurance Department that is given the responsibility to develop a risk adjustment mechanism that will apportion risk among the insurers participating in the Internet portal defined contribution market to protect insurers from adverse risk selection.
-Requires insurers who offer health benefit plans on the Internet portal to provide greater transparency and disclose information about the plan benefits, provider networks, wellness programs, claim payment practices, and solvency ratings.
-Establishes a process for a consumer to compare health plan features on the Internet portal and to enroll in a health benefit plan from the Internet portal.
-Requires the Office of Consumer Health Services to convene insurers and health care providers to monitor and report to the Health Reform Task Force and to the Business and Labor Interim Committee regarding progress towards expanding access to the defined contribution market, greater choice in the market, and
-Establishes limited rule making authority for the Office of Consumer Health Services to assist employers and insurance carriers with interacting with the Internet portal and facilitate the receipt and payment of health plan premium payments from multiple sources.
-Authorizes the Office of Consumer Health Services to establish a fee to cover the transaction cost associated with the Internet portal functions such as sending and processing an application or processing multiple premium payment sources; and
-Re-authorizes the Health Reform Task Force for one year.
