HOUSE BILL REPORT
SSB 5725
This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent. |
As Reported by House Committee On:
Health Care & Wellness
Title: An act relating to organ transplant lifetime limits.
Brief Description: Concerning health benefit plan coverage for organ transplants.
Sponsors: Senate Committee on Health & Long-Term Care (originally sponsored by Senator Keiser).
Brief History:
Committee Activity:
Health Care & Wellness: 3/24/09, 3/26/09 [DPA].
Brief Summary of Substitute Bill (As Amended by House) |
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HOUSE COMMITTEE ON HEALTH CARE & WELLNESS |
Majority Report: Do pass as amended. Signed by 13 members: Representatives Cody, Chair; Driscoll, Vice Chair; Ericksen, Ranking Minority Member; Bailey, Campbell, Clibborn, Green, Herrera, Hinkle, Kelley, Moeller, Morrell and Pedersen.
Staff: Dave Knutson (786-7146)
Background:
Comprehensive health insurance plans provide coverage for organ and tissue transplants. Transplants include single organ transplants such as heart, intestine, kidney, liver, lung, pancreas, multiple organ transplants, and tissue transplants such as bone marrow and cornea transplants. Many health benefit plans have lifetime maximum benefits that will be paid and many also have internal benefit maximums applied to specific benefits, such as a lifetime maximum on organ and tissue transplants of $250,000. An April 2008 Milliman Research Report on U.S. Organ and Tissue Transplant Cost Estimates displays the average estimated billed charges for various transplants: a cornea transplant is estimated at $20,700; a heart transplant is estimated at $787,000; and a heart-lung transplant is estimated at $1,123,800.
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Summary of Amended Bill:
After January 1, 2010, all health benefit plans that provide coverage for organ transplants are not allowed to include a separate lifetime limit on transplants that is any less than $350,000. The lifetime limit does not apply to chronic care that is provided beginning 90 days after the transplant.
Amended Bill Compared to Original Bill:
The lifetime limit does not apply to chronic care that is provided beginning 90 days after the transplant.
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Appropriation: None.
Fiscal Note: Available.
Effective Date of Amended Bill: The bill takes effect 90 days after adjournment of the session in which the bill is passed.
Staff Summary of Public Testimony:
(In support) Transplants are very expensive medical procedures. The current lifetime limit of $250,000 is too low. For many transplant patients there are ongoing therapies that should not be considered to be part of the lifetime limit related to the actual transplant.
(Opposed) None.
Persons Testifying: Senator Keiser, prime sponsor; Doug Fenton; John Scanlon; and Richard Murakami.
Persons Signed In To Testify But Not Testifying: Jackie Der.