6120-S AMS MOYE S5251.1

SSB 6120 - S AMD - 088

By Senators Moyer, Oke, Prince, Sellar, Morton, Winsley, Hochstatter, Finkbeiner, West, Anderson, Long, Deccio, Newhouse, McCaslin, Strannigan, Wood, McDonald, Hale, Swecker, Schow, Zarelli, Roach and Cantu

                                                   ADOPTED 2/12/96

    On page 9, line 25, after "implement" insert "sections 1 through 6 of"

    On page 9, after line 27, insert the following:

    "NEW SECTION. Sec. 8.  The legislature finds that residents of Washington require a system of maternity care that provides adequate prenatal and postnatal services to maintain and improve the health of women and their newborns.  The changing health care market challenges the ability of providers to ensure a system of such care.  The health care policy board has the authority to research, investigate, and develop options on issues on the scope, financing, and delivery of health care and has agreed to take on this task if requested by the legislature.

    Sec. 9.  RCW 43.73.030 and 1995 c 265 s 11 are each amended to read as follows:

    The board shall have the following powers and duties:

    (1) Periodically make recommendations to the appropriate committees of the legislature and the governor on issues including, but not limited to the following:

    (a) The scope, financing, and delivery of health care benefit plans including access for both the insured and uninsured population;

    (b) Long-term care services including the finance and delivery of such services in conjunction with the basic health plan by 1999;

    (c) The use of health care savings accounts including their impact on the health of participants and the cost of health insurance;

    (d) Rural health care needs;

    (e) Whether Washington is experiencing an increase in immigration as a result of health insurance reforms and the availability of subsidized and unsubsidized health care benefits;

    (f) The status of medical education and make recommendations regarding steps possible to encourage adequate availability of health care professionals to meet the needs of the state's populations with particular attention to rural areas;

    (g) The implementation of community rating and its impacts on the marketplace including costs and access;

    (h) The status of quality improvement programs in both the public and private sectors;

    (i) Models for billing and claims processing forms, ensuring that these procedures minimize administrative burdens on health care providers, facilities, carriers, and consumers.  These standards shall also apply to state-purchased health services where appropriate;

    (j) Guidelines to health carriers for utilization management and review, provider selection and termination policies, and coordination of benefits and premiums; and

    (k) Study the feasibility of including long-term care services in a medicare supplemental insurance policy offered according to RCW 41.05.197;

    (2) Review rules prepared by the insurance commissioner, health care authority, department of social and health services, department of labor and industries, and department of health, and make recommendations where appropriate to facilitate consistency with the goals of health reform;

    (3) Make recommendations on a system for managing health care services to children with special needs and report to the governor and the legislature on their findings by January 1, 1997;

    (4) Conduct a comparative analysis of individual and group insurance markets addressing:  Relative costs; utilization rates; adverse selection; and specific impacts upon small businesses and individuals.  The analysis shall address, also, the necessity and feasibility of establishing explicit related policies, to include, but not be limited to, establishing the maximum allowable individual premium rate as a percentage of the small group premium rate.  The board shall submit an interim report on its findings to the governor and appropriate committees of the legislature by December 15, 1995, and a final report on December 15, 1996;

    (5) Conduct an analysis of the financing and delivery of maternity care included in public and private individual and group insurance markets and address and develop options for a system of maternity care that includes, but is not limited to, appropriate level of prenatal, inpatient, and outpatient care, physical assessment of the newborn, the performance of any medically necessary and appropriate clinical tests, parent education, lactation and bottle feeding education, and assistance and assessment of home support;

(6) Develop sample enrollee satisfaction surveys that may be used by health carriers."

SSB 6120 - S AMD - 088

By Senators Moyer, Sellar, Morton, Winsley, Hochstatter, Finkbeiner, West, Anderson, Long, Deccio, Newhouse, Moyer, McCaslin, Strannigan, Wood, McDonald, Hale, Swecker, Schow, Zarelli, Roach, Cantu and Prince

                                                   ADOPTED 2/12/96

    On page 1, line 2 of the title, after "child;" insert "amending RCW 43.73.030;"

EFFECT:  Adds a new section of legislative intent regarding Washington's maternity care system and states the agreement of the Health Policy Board to conduct research and analysis of that system.

EFFECT:  Adds an analysis of Washington's maternity care system to the powers and duties of the Health Policy Board.

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