6034 AAS 3/7/95

SB 6034 - S AMD   043

By Senator Moyer

                                       ADOPTED W/IN SCOPE - 3/7/95

    On page 1, after line 4, insert the following:

    "Sec. 1.  RCW 43.72.810 and 1993 c 492 s 474 are each amended to read as follows:

    (1) The commission shall determine the state and federal laws that would need to be repealed, amended, or waived to implement chapter 492, Laws of 1993, and report its recommendations, with proposed revisions to the Revised Code of Washington, to the governor, and appropriate committees of the legislature by July 1, 1994.

    (2) The governor, in consultation with the commission, shall take the following steps in an effort to receive waivers or exemptions from federal statutes necessary to fully implement chapter 492, Laws of 1993 to include, but not be limited to:

    (a) Negotiate with the United States congress and the federal department of health and human services, health care financing administration to obtain a statutory or regulatory waiver of provisions of the medical assistance statute, Title XIX of the federal social security act that currently constitute barriers to full implementation of provisions of chapter 492, Laws of 1993 related to access to health services for low-income residents of Washington state.  Such waivers shall include any waiver needed to require that:  (i) Medical assistance recipients enroll in managed care systems, as defined in chapter 492, Laws of 1993; and (ii) enrollee point of service, cost-sharing levels adopted pursuant to RCW 43.72.130 be applied to medical assistance recipients.  In negotiating the waiver, consideration shall be given to the degree to which supplemental benefits should be offered to medicaid recipients, if at all.  Waived provisions may include and are not limited to:  Categorical eligibility restrictions related to age, disability, blindness, or family structure; income and resource limitations tied to financial eligibility requirements of the federal aid to families with dependent children and supplemental security income programs; administrative requirements regarding single state agencies, choice of providers, and fee for service reimbursement; and other limitations on health services provider payment methods.

    (b) Negotiate with the United States congress and the federal department of health and human services, health care financing administration to obtain a statutory or regulatory waiver of provisions of the medicare statute, Title XVIII of the federal social security act that currently constitute barriers to full implementation of provisions of chapter 492, Laws of 1993 related to access to health services for elderly and disabled residents of Washington state.  Such waivers shall include any waivers needed to implement managed care programs.  Waived provisions include and are not limited to:  Beneficiary cost-sharing requirements; restrictions on scope of services; and limitations on health services provider payment methods.

    (c) Negotiate with the United States congress and the federal department of health and human services to obtain any statutory or regulatory waivers of provisions of the United States public health services act necessary to ensure integration of federally funded community and migrant health clinics and other health services funded through the public health services act into the health services system established pursuant to chapter 492, Laws of 1993.  The commission shall request in the waiver that funds from these sources continue to be allocated to federally funded community and migrant health clinics to the extent that such clinics' patients are not yet enrolled in certified health plans.

    (d) ((Negotiate with the United States congress to obtain a statutory exemption from provisions of the employee retirement income security act that limit the state's ability to ensure that all employees and their dependents in the state comply with the requirement to enroll in certified health plans, and have their employers participate in financing their enrollment in such plans.

    (e))) Request that the United States congress amend the internal revenue code to treat employee premium contributions to plans, such as the basic health plan or the uniform benefits package offered through a certified health plan, as fully deductible from adjusted gross income.

    (3) On or before December 1, 1995, the commission shall report the following to the appropriate committees of the legislature:

    (a) The status of its efforts to obtain the waivers provided in subsection (2) of this section;

    (b) If all federal statutory or regulatory waivers necessary to fully implement chapter 492, Laws of 1993 have not been obtained:

    (i) The extent to which chapter 492, Laws of 1993 can be implemented without receipt of all of such waivers; and

    (ii) Changes in chapter 492, Laws of 1993 necessary to implement a residency-based health services system using one or a limited number of sponsors, or an alternative system that will ensure access to care and control health services costs."

    Renumber the remaining sections consecutively and correct internal references accordingly.

SB 6034 - S AMD

By Senator Moyer

                                                  ADOPTED - 3/7/95

    On page 1, line 2 of the title, after "employers;" insert "amending RCW 43.72.810;"

EFFECT:  ERISA waivers.

                            --- END ---