00RS HB517


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HB 517/HM (BR 1859) - K. Bratcher, B. DeWeese, B. Colter, R. Crimm, R. Damron, J. Gooch, S. Nunn, J. Reinhardt, M. Weaver, S. Westrom

     AN ACT relating to health insurance.
     Create a new section of KRS 304.17A-500 to 304.17A-570 to define "hospitalist;" provide that a contract between a managed care plan and a physician shall not require the mandatory use of a hospitalist.


     SFA (1, D. Williams) - Retain original provisions; establish Subtitle 17B of KRS Chapter 304 and create new sections thereof to create the Kentucky Health Care Improvement Authority; designate 13 members and name the Insurance Commissioner as chair; provide that 70 percent of moneys in the fund be placed in the Kentucky Access Fund, 20 percent be spent on collaborative partnership between the University of Louisville and the University of Kentucky dedicated to lung cancer research, and 10 percent be spent to discourage the use of harmful substances by minors; create Kentucky Access to assure health coverage is made available to each Kentucky resident; provide that Kentucky Access shall operate under the supervision of the Department of Insurance; provide that the department select a third-party administrator to administer Kentucky Access; direct the department to establish the schedule of rates, premiums, deductibles, copayments amounts, coinsurance amounts, and other cost-sharing amounts; provide that health coverage begin no sooner than January 1, 2001; require the department to separate its duties and responsibilities in operating the department from its duties and responsibilities in operating Kentucky Access; require a statewide provider network; provide that initial premium rates shall not exceed 150% of the applicable individual standard risk rates, and that premium rates in no event shall exceed 175% of the rates applicable to individual standard risks; provide that an "eligible individual" is eligible for coverage if the person has been a Kentucky resident for at least 12 months if the person has been rejected by at least 2 insurers or has been offered coverage substantially similar to Kentucky Access coverage at a premium greater than the Kentucky Access premium or the person has a high-cost condition; direct that a Kentucky Access enrollee whose premiums have exceeded claims for 3 years be given a notice of insurability to be used to obtain insurance in the regular individual market; prohibit certain persons from eligibility for Kentucky Access, including persons eligible for Medicare or Medicaid, persons terminated by Kentucky Access less than 12 months ago, persons who have received $2 million in Kentucky Access benefits, and prisoners; to provide that the department evaluate and revise as necessary rates to be charged to enrollees; require Kentucky Access to provide at least 3 health benefit plans, at least one of which must be the standard plan and at one of which must be a traditional fee-for-service form; prohibit pre-existing condition exclusions for "eligible individuals" but permit them for others; permit the department to assess all insurers to fund GAP loses prior to September 30, 2002, and to fund Kentucky Access; provide as funding sources for Kentucky Access the premiums paid by enrollees, funds designated in the Kentucky Health Care Improvement Fund, appropriations, premium taxes, annual assessments of insurers, second assessment of insurers, gifts and grants, interest on earnings, and funds in GAP account on October 1, 2000; allow insurers to include assessments in any rate filing; require GAP participating insurers to report certain information; direct that GAP be terminated on October 1, 2000; exempt Kentucky Access and the department from state and local taxes; provide that GAP participating insurers shall be reimbursed for actual guaranteed acceptance program losses only if money is available after funding Kentucky Access; require the department to submit an annual report to the General Assembly 60 days prior to each regular session; amend KRS 304.17A-005 to conform, amend KRS 304.17A-080 to increase number of members on Health Insurance Advisory Council from 7 to 9, by adding 2 agents' representatives; amend KRS 304.17A-0952 to provide that premium rates charged to an individual may vary from the index rate by 50 percent or less for two consecutive years from the date of implementation of Kentucky Access; permit an adjustment of 20 percent for individual, small group, or association rates; provide that the premium rate charged to a small group or association shall not vary from the index rate by more than 40 percent for 2 consecutive years; allow insurers to establish a separate class of business to separate guaranteed acceptance program qualified individuals from other individuals; amend KRS 304.17A-150 to conform; amend KRS 304.17A-250 to require in the individual market that the insurer must offer the standard plan; require the denial letter after October 1, 2000, to include a description of Kentucky Access; amend KRS 304.17A-260 to permit insurers who ceased operating in Kentucky to reenter until January 1, 2001; amend KRS 304.17A-320 to conform; specify requirements for minimum loss ratio filing; require audit of minimum loss ratio results; require insurers to refund premiums necessary to bring actual loss ratio up to the guaranteed minimum loss ratio; amend KRS 304.17A-080, KRS 304.17A-095, KRS 304.17A-150, KRS 304.17A-250, KRS 304.17A-290, and KRS 304.17A-320 to conform; repeal the following statutes: KRS 304.17A-400, KRS 304.17A-410, KRS 304.17A-420, KRS 304.17A-430, KRS 304.17A-440, KRS 304.17A-450, KRS 304.17A-460, KRS 304.17A-470, and KRS 304.17A-480.
     SFA (2/Title, D. Williams) - Make title amendment.
     CCR - Conference Committee could not agree and requested Free Conference Committee be appointed.
     FCCR (Majority Report) - Adopt the provisions of Senate floor amendment 1 to HB 517/GA and make technical changes; provide that the Guaranteed Acceptance Program shall remain in effect except for KRS 304.17A-400, 304.17A-420, 304.17A-440, 304.17A-460, 304.17A-470, and 304.17A-480; amend KRS 304.17A-150 to make it an unfair trade practice for a health insurer to require a health care provider to participate in all plans offered by the insurer when the provider chooses to participate in one or more but not all plans; amend KRS 304.17A-515 to require managed care plans to demonstrate that the provider network meets accessibility requirements based on urban areas and areas other than urban areas; allow premium rates for small group, association, and employer-organized association plans to vary from the index rate by not more than 50 percent for two years beginning on January 1, 2001; amend KRS 91A.080 to exempt policies issued to individuals and policies issued through Kentucky Access from the license fees or taxes imposed on insurance companies by cities, counties, and urban-county governments; and increase the membership of the Kentucky Health Care Improvement Authority from 13 to 15 members by adding two additional members of the Kentucky General Assembly for two year terms.

     Feb 1-introduced in House
     Feb 2-to Banking and Insurance (H)
     Feb 8-posted in committee
     Feb 17-reported favorably, 1st reading, to Calendar
     Feb 18-2nd reading, to Rules; posted for passage in the Regular Orders of the Day for Tuesday, February 22, 2000
     Feb 23-3rd reading, passed 96-0
     Feb 24-received in Senate
     Feb 28-to Health and Welfare (S)
     Mar 8-reported favorably, 1st reading, to Consent Calendar
     Mar 9-2nd reading, to Rules
     Mar 13-posted for passage in the Consent Orders of the Day for Thursday, March 16, 2000
     Mar 15-floor amendments (1) and (2-title) filed
     Mar 16-taken from the Consent Orders of the Day, placed in the Regular Orders of the Day; 3rd reading, passed 19-13 with floor amendments (1) and (2-title)
     Mar 17-received in House; posted for passage for concurrence in Senate floor amendments (1) and (2-title)
     Mar 28-House refused to concur in Senate floor amendments (1) and (2-title) ; received in Senate; posted for passage for receding from Senate floor amendments (1) and (2-title) Tuesday, March 28, 2000; Senate refused to recede from floor amendments (1) and (2-title) ; Conference Committee appointed in House and Senate; Conference Committee report filed in House and Senate; Conference Committee report adopted in House and Senate; Free Conference Committee appointed in House and Senate
     Mar 29-Free Conference Committee report filed in House and Senate; Free Conference Committee report adopted in Senate; passed 19-18; Free Conference Committee report adopted in House; passed 45-44
     Apr 11-enrolled, signed by each presiding officer, delivered to Governor
     Apr 21-signed by Governor (Acts ch. 476)

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