Introduced
by
To eliminate a requirement that HMO benefit plans include certain specified “basic health services” and require instead that they only include certain specified "preventive health care services." This would allow HMOs to offer various lower cost "stripped down" health plan options that focus more on preventative care.
Referred to the Committee on Health Policy
Reported without amendment
With the recommendation that the substitute (S-1) be adopted and that the bill then pass.
Substitute offered
To replace the previous version of the bill with one that eliminates the original provisions, and instead caps coinsurance levels. See Senate-passed version for details.
The substitute passed by voice vote
Amendment offered
by
To cap the medical service co-payments required of an insured person once the insurance deductible level has been reached.
The amendment failed 18 to 19 (details)
Passed in the Senate 26 to 11 (details)
To cap an HMO enrollee's coinsurance for basic health services and copayments for inpatient hospital services at 50% of the HMO's contracted reimbursement rate to an affiliated health care provider. Also, to limit an enrollee's annual aggregate out-of-pocket costs for coinsurance and copayments to $5,000 for an individual and $10,000 for a family. Also, to establish that an HMO participating in a government health program would not have to offer benefits or services in excess of the program's requirements. The bill has the effect of giving HMOs more flexibility in designing health care packages.
Referred to the Committee on Insurance and Financial Services
Reported without amendment
Without amendment and with the recommendation that the bill pass.
Passed in the House 56 to 41 (details)
To cap an HMO enrollee's coinsurance for basic health services and copayments for inpatient hospital services at 50% of the HMO's contracted reimbursement rate to an affiliated health care provider. Also, to limit an enrollee's annual aggregate out-of-pocket costs for coinsurance and copayments to $5,000 for an individual and $10,000 for a family. Also, to establish that an HMO participating in a government health program would not have to offer benefits or services in excess of the program's requirements. The bill has the effect of giving HMOs more flexibility in designing health care packages.
