HB1493 (2012) Detail

Relative to copayments for certain specialists.


HB 1493-FN – AS INTRODUCED

2012 SESSION

12-2142

01/03

HOUSE BILL 1493-FN

AN ACT relative to copayments for certain specialists.

SPONSORS: Rep. Weyler, Rock 8; Rep. Major, Rock 8; Rep. Ward, Rock 13

COMMITTEE: Commerce and Consumer Affairs

ANALYSIS

This bill declares that an insurer shall not charge a copayment, coinsurance, or office visit deductible for certain specialists that is greater than a copayment, coinsurance, or office visit deductible for an office visit to a licensed physician or osteopath.

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

12-2142

01/03

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Twelve

AN ACT relative to copayments for certain specialists.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 New Section; Copayments for Certain Specialists. Amend RSA 415 by inserting after section 6-q the following new section:

415:6-r Copayments, Coinsurance, or Office Visit Deductible for Certain Specialists. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance that constitutes health coverage for the services of occupational therapists, licensed under RSA 326-C, physical therapists, licensed under RSA 328-A, or speech-language pathologists, licensed under RSA 326-F shall not charge a copayment, coinsurance, or office visit deductible that is greater than the copayment, coinsurance, or office visit deductible amount charged to the insured for the services of a primary care physician or an osteopath licensed under RSA 329 for an office visit.

2 New Section; Copayments for Certain Specialists. Amend RSA 415 by inserting after section 18-v the following new section:

415:18-w Copayments, Coinsurance, or Office Visit Deductible for Certain Specialists. Each insurer that issues or renews any policy of group or blanket accident or health insurance that constitutes health coverage for the services of occupational therapists, licensed under RSA 326-C, physical therapists, licensed under RSA 328-A, or speech-language pathologists, licensed under RSA 326-F shall not charge a copayment, coinsurance, or office visit deductible that is greater than the copayment, coinsurance, or office visit deductible amount charged to the insured for the services of a primary care physician or an osteopath licensed under RSA 329 for an office visit.

3 Health Service Corporations; Coverage Provided by Certain Specialists. Amend RSA 420-A:2 to read as follows:

420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:18, V, [RSA 415:18, VII(g),] RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.

4 Health Maintenance Corporations; Coverage for Certain Specialists. Amend RSA 420-B:20, III to read as follows:

III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, [RSA 415:18, VII(g),] RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.

5 Effective Date. This act shall take effect 60 days after its passage.

LBAO

12-2142

11/29/11

HB 1493-FN - FISCAL NOTE

AN ACT relative to copayments for certain specialists.

FISCAL IMPACT:

      The Department of Insurance states this bill will have an indeterminable fiscal impact on state revenues, and state, county and local expenditures in FY 2012 and each year thereafter. This bill will have no fiscal impact on county or local revenues.

METHODOLOGY:

    The Department of Insurance states this bill requires that co-pays charged for certain specialists not exceed the co-pays charged for primary care physicians. The Department assumes, for plans where co-pays for these specialty providers exceed the co-pays for primary care physicians, the bill would result in an increase in premiums and premium tax revenue to the state general fund. This increase would result from additional cost to the insurer and an increase in utilization by the insured. County and local expenditures may increase to the extend employer paid health insurance premiums increase. The Department is not able to estimate the premium increase or the amount of the increase that may be offset by other policy changes such as benefit reductions or buy-downs. The Department assumed an effective date of April 1, 2012.

    The Department of Administrative Services states this bill will have no fiscal impact on the state employee and retiree health benefit program. The Department states the program is self-funded and not subject to the provisions of this bill. In addition, the Department indicates co-payments for the state employees’ coverage are controlled by collective bargaining agreements and the co-payments currently are the same for specialty providers and primary care physicians.

Links

HB1493 at GenCourtMobile

Action Dates

Date Body Type

Bill Text Revisions

HB1493 Revision: 21488 Date: Dec. 14, 2011, midnight

Docket