SENATE BILL REPORT

ESB 6269

BYSenators West, Wojahn, Smith, Johnson, McDonald, von Reichbauer and Rasmussen

Providing for a uniform health care insurance claim form.

Senate Committee on Health & Long-Term Care

Senate Hearing Date(s):January 17, 1990; February 1, 1990

Majority Report:  Do pass as amended.

      Signed by Senators West, Chairman; Smith, Vice Chairman; Amondson, Johnson, Wojahn.

Senate Staff:Don Sloma (786-7414)

                  February 12, 1990

AS PASSED SENATE, FEBRUARY 9, 1990

BACKGROUND:

The Insurance Commissioner licenses over 200 health care service contractors, health maintenance organizations, and disability insurance companies to provide hospital and other medical services in Washington.  Many of these groups use different forms, often requiring similar or identical information.  Observers of health care financing structures have suggested that significant administrative cost reductions might be possible if these companies used a single billing form.  Such a form might reduce administrative costs at the service provider level as well as at the payor level.

SUMMARY:

The State Insurance Commissioner must develop a uniform health care insurance claim form to be used by all carriers licensed under state insurance codes and all other health plans, whether or not subject to state regulation, by July 1, 1992.  The commissioner may establish an advisory committee to assist in implementing the form.  The commissioner must aggressively pursue federal regulatory changes which might be necessary to assure compliance with this requirement.

All group disability insurance plans, health care service insurance contractors, health maintenance organizations and long-term care insurance and benefit contracts that provide hospital and medical benefits must accept the form by July 1, 1992.

Appropriation:    none

Revenue:    none

Fiscal Note:      available

Senate Committee - Testified: Mel Sorensen, Washington Physicians Service/Blue Cross; Len Eddinger, WSMA; Susie Tracy, WA Clinic Managers Association; Lars Hennum, Pharmacists of WA; Dave Broderick, Hospital Association; Bob Crittenden, Governor's office