| Last Action | to Appropriations & Revenue (S) |
|---|---|
| Title | AN ACT relating to health insurance coverage for dialysis patients |
| Bill Documents |
Bill
|
| Impact Statements | Health Mandate |
| Bill Request Number | 1622 |
| Sponsors | S. Westrom, T. Thompson, D. Horlander, M. Marzian |
| Summary of Original Version | Create new sections of Subtitle 17A of KRS Chapter 304 to require a health benefit plan with a provider network to provide coverage for the dialysis provider of the insured's choice; establish a method of determining the payment rate for out-of-network dialysis services; prevent restriction of the insured's choice; prevent restriction of the dialysis benefit during open enrollment; define "unreasonable distance" and prohibit travel of such distance for in-network dialysis service; provide coverage for out-of-network dialysis if the distance for in-network dialysis is unreasonable; require written notice of any change to a health plan with a provider network that would affect a dialysis patient's coverage or benefit level concerning out-of-network coverage; require payment directly to the dialysis provider and not to the patient; require the executive director of the Office of Insurance to conduct a review of all findings to determine compliance within 120 days of the effective date of this Act; require insurers to notify the office of any violations; authorize the office to promulgate necessary regulations to implement the provisions of the Act; provide that the new sections may be cited as the "Dialysis Patients' Bill of Rights"; create a new section of Subtitle 99 of KRS Chapter 304 to establish fines for violations; amend KRS 304.17A-550 to conform. |
| Index Headings of Original Version |
Health Benefit Mandate - Health insurance, dialysis patients Insurance - Health insurance, dialysis patients Insurance, Health - Dialysis patients coverage, bill of rights Insurance, Health - Dialysis patients, out-of-network coverage |
| Proposed Amendments |
House Committee Substitute 1 House Floor Amendment 1 |
| Votes | Vote History |
| 01/31/08 |
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|---|---|
| 02/01/08 |
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| 02/14/08 |
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| 03/05/08 |
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| 03/06/08 |
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| 03/12/08 |
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| 03/17/08 |
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| 03/19/08 |
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| 03/20/08 |
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| 03/26/08 |
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| Amendment | House Committee Substitute 1 |
|---|---|
| Impact Statements | Health Mandate |
| Summary | Delete original provisions; create a new section of Subtitle 17A of KRS Chapter 304 to prohibit discrimination against an insured based on the insured's need for dialysis, except as defined by contract; prohibit balance billing by dialysis providers; provide that out-of-network reimbursement for dialysis services be based on historical payment amounts, and the payment shall be no lower than the predominant payment to that dialysis provider for services rendered prior to January 1, 2007 in the Commonwealth; prohibit consideration of Medicare and Medicaid reimbursement levels when determining reimbursement amounts; allow a decrease in the reimbursement amount up to 3% in any year; require reimbursement for dialysis to be made directly to the provider; create a new section of Subtitle 99 of KRS Chapter 304 to establish fines of $1000 to $10,000 for violations of this Act; and, amend KRS 304.17A-550 and 304.18-040 to conform. |
| Index Headings |
Health Benefit Mandate - Health insurance, dialysis patients Insurance - Health insurance, dialysis patients Insurance, Health - Dialysis patients coverage, bill of rights Insurance, Health - Dialysis patients, out-of-network coverage |
| Amendment | House Floor Amendment 1 |
|---|---|
| Sponsor | S. Westrom |
| Summary | Amend by deleting subsection (1) and providing in lieu thereof that insurance plan benefits for dialysis services shall be similar to other major medical coverage in the plan; amend subsection (3)(a) to provide that reimbursement for dialysis services shall be the average payment rate agreed to between the insurer and the dialysis provider for out-of-network services rendered in the Commonwealth during calendar year 2006; define "dialysis provider." |
| Index Headings |
Health Benefit Mandate - Health insurance, dialysis patients Insurance - Health insurance, dialysis patients Insurance, Health - Dialysis patients coverage, bill of rights Insurance, Health - Dialysis patients, out-of-network coverage |
Last updated: 8/28/2019 8:09 AM (EDT)