HOUSE BILL REPORT

                     ESB 6037

                     As Reported By House Committee on:

                                Health Care

Title:  An act relating to health care insurance claims.

Brief Description:  Requiring a uniform health care insurance claim form.

Sponsor(s):  Senators West, Rinehart, Rasmussen and Johnson.

Brief History:

   Reported by House Committee on:

Health Care, February 27, 1992, DPA.

HOUSE COMMITTEE ON

HEALTH CARE

Majority Report: Do pass as amended.  Signed by 11 members:  Representatives Braddock, Chair; Day, Vice Chair; Moyer, Ranking Minority Member; Casada, Assistant Ranking Minority Member; Cantwell; Edmondson; Franklin; Morris; Paris; Prentice; and Sprenkle.

Staff:  Bill Hagens (786-7131).

Background:  Several hundred health care service contractors, health maintenance organizations, and disability insurance companies, in addition to several government agencies, provide hospital and other medical services in Washington.  Many of these providers use different forms, often requiring similar or identical information.  Observers of health care financing structures have suggested that significant administrative cost reductions might be possible if the number of different billing forms used could be reduced.

Summary of Amended Bill:  All private health insurance carriers in Washington shall use for billing purposes the HCFA 1500 form, or its successor, or the UB 82 form, or its successor, after January 1, 1994.  The state agencies that purchase health care shall adopt these forms by July 1, 1994.

Exempt from the requirements are pharmacists, dentists, nursing services, eyeglasses, transportation or vocational services.

The basic health plan administrator, the secretary of social and health services, the health care authority administrator and the director of labor and industries shall develop, jointly, by January 1, 1993 forms to cover billing for these services.  These forms shall be used by private insurance carriers after January 1, 1994 and by the state agencies that purchase health care services after July 1, 1994.

Amended Bill Compared to Engrossed Bill:  The reference to home health care is deleted from the exempted category.  Home health care is currently included in the HCFA 1500 form.

Fiscal Note:  Not requested.

Effective Date of Amended Bill:  Ninety days after adjournment of session in which bill passed.

Testimony For:  The bill puts in effect what is general practice.

Testimony Against:  None.

Witnesses:  Jim Peterson, Department of Social and Health Services (pro); Betty Jorgensen, Washington State Home Care Association (pro); Carl Nelson, Washington State Medical Association (pro); and Mel Sorenson, Washington Physician Service and Blue Cross (pro).