HB 1890 Enacts various health insurance and medical malpractice insurance laws

Current Bill Summary

- Prepared by Senate Research -


HCS/HB 1890 - This act enacts various provisions relating to health insurance and medical malpractice insurance.

STATE HEALTH INSURANCE MANDATES ACTUARIAL ANALYSIS - Under this act, the Oversight Division of the Joint Committee on Legislative Research must conduct an actuarial analysis of the cost impact to consumers, health insurers, and other private and public payers if state mandates were enacted to provide health benefit plan coverages for the following:

(1) Orally administered anticancer medication that is used to kill or slow the growth of cancerous cells than what the plan requires for an intravenously administered or injected cancer medication that is provided, regardless of formulation or benefit category determination by the health carrier administering the health benefit plan;

(2) Diagnosis and treatment of eating disorders that includes residential treatment and access to psychiatric and medical treatments; and

(3) Diagnosis and treatment of infertility that includes in vitro fertilization, uterine embryo lavage, embryo transfer, artificial insemination, intrafallopian tube transfer, and low tubal ovum transfer.

Under the terms of the act, the division director must submit a report of the actuarial findings to the Speaker of the House of Representatives, President Pro Tem of the Senate, and the chair of the House Special Committee on Health Insurance and the Senate Small Business, Insurance and Industry Committee by December 31, 2012. The actuarial analysis shall assume that the mandated coverage will not be subject to any greater deductible or copayment than other health care services provided under a health benefit plan and will not apply to a supplemental insurance policy. The cost for each actuarial analysis cannot exceed $30,000 and the division may utilize any actuary contracted to perform services for the Missouri Consolidated Health Care Plan to perform the analysis required under the act. The provisions regarding the actuarial analysis expire December 31, 2012 (Section 376.1192).

PROHIBITION AGAINST FEE CAPPING FOR NON-COVERED DENTAL SERVICES - This act prohibits a contract between a health carrier and a dentist from requiring the dentist to provide services to an insured at a fee established by the carrier if the services are not covered under the plan. The act further provides that a health carrier, health benefit plan, or third-party administrator cannot provide an insignificant reimbursement or coverage in an effort to avoid the fee cap prohibition (Section 376.1226).

MEDICAL MALPRACTICE REQUIREMENTS FOR CERTAIN PHYSICIANS - Under this act, a physician who prescribes or administers any drug for the purpose of inducing an abortion must obtain, in addition to all other medical malpractice requirements, a tail or occurrence-based insurance policy of at least $1 million per occurrence and $3 million in the aggregate per year for damages for the personal injury to or death of a child who is born alive after an attempted abortion. The medical malpractice insurance policy must remain in full force and effect until the child reaches his or her twenty-first birthday, or later under the applicable statute of limitations. Under the act, a physician who violates this provision of the act shall be guilty of a Class D felony. The defense of medical emergency must be available to any physician alleged to have violated this portion of the act (Section 376.1760).

ACTUARIAL ANALYSIS OF INCLUDING MODOT WITHIN MCHCP - Under this act, the board of trustees of the Missouri Consolidated Health Care Plan is required to conduct an actuarial analysis and report to the General Assembly by December 31, 2012, on the feasibility of including the health plans sponsored by the Department of Transportation into the Missouri Consolidated Health Care Plan (Section 1).

STEPHEN WITTE


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