ANALYSIS OF HOUSE BILL 2482

  Accessing specialty health care services.

Health Care Committee                           27 January 1998

Washington State House of Representatives

SPONSORS:  Representatives Schoesler and Sump.

PURPOSE:  To establish a mandated benefit for certain types of hospital consultations.

BACKGROUND:  For the most part, a physician=s access to a second opinion or consultation from a teaching and tertiary care hospital depends on the coverage included in their patients= health plan and hospital=s location, which may cause inconsistency in access.  For example, a Seattle physician, most likely, can get a second opinion from University Hospital faster than her or his counterpart in a rural area of Eastern Washington.  Proponents of this measure feel that this is unfair because most of these hospitals are supported from taxes drawn from all regions of the state.

SUMMARY:  The Administrator of public employee benefit plans and the Basic Health Plan and every health carrier that offers or provides coverage for hospital services must permit a doctor of Medicine and Osteopathy who is treating a covered person to timely access  consultations from certain teaching and tertiary care hospitals, e.g., University, Haborview, and Children=s in Seattle, and Mary Bridge in Tacoma..

Carriers may establish administrative procedures for this access.

Standards of medical care are not established nor are unnecessary medical services authorized.