SHB 1728 - H AMD 0086 ADOPTED 3/14/01

By Representative Campbell

On page 1, line 3, strike everything after the enacting clause, and insert the following:

"NEW SECTION. Sec. 1.

(1) The insurance commissioner shall establish the task force on third party administrator regulation. The task force shall consist of thirteen members. The co-speakers of the house of representatives shall select two member from the house of representatives, one from each political caucus, and the president of the senate shall select two members from the senate, one from each political caucus. The commissioner shall select two members representing health carriers, one member representing third party administrators with a contractual relationship with a health carrier, one member representing health care purchasers, two members representing licensed health care providers, two member representing consumers, and one representative of the office of insurance commissioner, who shall act in an ex officio capacity.

(2) The task force shall review the need for regulation of third party administrators, including:

(a) network adequacy and disclosure of network adequacy standards;

(b) provider application and credentialing processes;

(c) the consistency of third party administrator standards and benefit packages sold by health carriers, including utilization guidelines;

(d) the revocation of prior authorization;

(e) the receipt of provider claims; and

(f) the classes of third party administrators that should be subject to state regulation.

(3) The task force shall report its findings and recommendations to the legislature no later than December 15, 2001. In conducting its work, the task force shall monitor the development of the National Association of Insurance Commissioners proposal to develop a model state statute on the regulation of third party administrators, and incorporate appropriate elements of the model statute in its recommendation to the legislature.

NEW SECTION. Sec.2. This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its specific public institutions, and takes effect immediately."