HOUSE BILL REPORT
SSB 5165
This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent. |
As Reported by House Committee On:
Health Care & Wellness
Title: An act relating to coverage of home health benefits for persons seeking palliative care treatments.
Brief Description: Authorizing palliative care in conjunction with treatment or management of serious or life-threatening illness.
Sponsors: Senate Committee on Health Care (originally sponsored by Senators Angel and Frockt).
Brief History:
Committee Activity:
Health Care & Wellness: 3/13/15, 3/17/15 [DP].
Brief Summary of Substitute Bill |
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HOUSE COMMITTEE ON HEALTH CARE & WELLNESS |
Majority Report: Do pass. Signed by 15 members: Representatives Cody, Chair; Riccelli, Vice Chair; Schmick, Ranking Minority Member; Harris, Assistant Ranking Minority Member; Caldier, Clibborn, DeBolt, Jinkins, Johnson, Moeller, Robinson, Rodne, Short, Tharinger and Van De Wege.
Staff: Jim Morishima (786-7191).
Background:
Group disability insurers offering group, blanket, or extended health coverage and health care services contractors must offer optional coverage for home health care and hospice care for persons who are homebound and would otherwise require hospitalization. The coverage only has to be offered in conjunction with a hospitalization benefit offered by the carrier.
The coverage:
may be subject to reasonable deductibles, coinsurance, internal maximums, and utilization review;
should be structured to incentivize the use of home health care and hospice care as an alternative to hospitalization;
may require written treatment plans;
must cover only services rendered by home health and hospice agencies licensed by the Department of Social and Health Services;
must provide at least six months of hospice coverage, which may be extended for an additional six months if the patient is facing imminent death or is entering remission;
must provide coverage for at least 130 home health care visits per year; and
may be structured to prevent the duplication of services or supplies in the primary contract.
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Summary of Bill:
A person who is not homebound is eligible for optional home health care and hospice coverage if he or she is seeking the services for palliative care in conjunction with treatment or management of serious or life-threatening illness.
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Appropriation: None.
Fiscal Note: Available.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.
Staff Summary of Public Testimony:
(In support) Currently, a person must be homebound in order to access insurance coverage for home health services. While this may be appropriate in many cases, it is inappropriate where people are seeking palliative care for serious illnesses. A patient with a serious illness who is able to leave his or her home for a limited period of time does not meet the definition of homebound and is therefore ineligible for the home health benefit. This prevents these patients from maximizing their quality of life by discouraging activities like going to their kids' soccer games or school functions. These people should be able to have lives outside of the home. People with serious, life-threatening illnesses often have trouble accessing care. The lack of insurance reimbursement for these services is a barrier to expansions of these services in settings like hospitals, nursing homes, and assisted living facilities. People with serious illnesses should not have to be homebound in order to access palliative care.
(Opposed) None.
Persons Testifying: Senator Angel, prime sponsor; Chris Bandoli, Regence Blue Shield; Leslie Emerick, Washington State Hospice and Palliative Care Organization; and Cynthia Tomik, Home Care Association of Washington.
Persons Signed In To Testify But Not Testifying: None.