FINAL BILL REPORT

                 SHB 1535

                          C 64 L 99

                     Synopsis as Enacted

Brief Description:  Reimbursing podiatric physicians and surgeons.

Sponsors:  By House Committee on Health Care (Originally sponsored by Representatives Parlette, Cody, Schual‑Berke, Romero, Ruderman, Esser, Hatfield, Boldt, Campbell, Pflug and Alexander).

House Committee on Health Care

Senate Committee on Health & Long-Term Care

Background:

Health maintenance organizations are registered by the Insurance Commissioner to provide comprehensive health care services to their enrolled participants on a group practice per capita prepayment basis or on a prepaid individual practice plan.  Health maintenance organizations either provide these services directly through their own health care panels, or they may contract with an independent network of providers, reimbursing them for their services.

Foot care services are traditionally included in the array of health care benefits provided by health maintenance organizations.

State law prohibits traditional indemnity insurers, including disability carriers, group disability carriers, and health care service contractors, from discriminating in reimbursement between physicians, osteopathic physicians, and podiatric physicians. However, there is no such law applying to health maintenance organizations.

Summary:

A health maintenance organization that exclusively contracts with an independent network of providers for the provision of foot care services to its enrolled participants may not discriminate in terms, conditions, and reimbursement between physicians, osteopathic physicians, and podiatric physicians. 

Obligations under existing contracts are not affected.

Votes on Final Passage:

House970

Senate420

Effective:July 25, 1999