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                                 ENGROSSED SUBSTITUTE HOUSE BILL NO. 1074

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State of Washington                               51st Legislature                              1989 Regular Session

By House Committee on Financial Institutions & Insurance (originally sponsored by Representatives Haugen, Walker, Winsley, Leonard, Cole, Hankins, S. Wilson, Ferguson, Nutley, Scott, Belcher, Anderson, Basich, Dellwo, Spanel, Braddock, Brough, Horn, Todd, Nelson, Brekke, Rector, Appelwick, Hine, Heavey, Baugher, Kremen, Cooper, Zellinsky, K. Wilson, Wood, Rayburn, Jesernig, Jacobsen, R. Fisher, R. King, Rust, Pruitt, Wang, Grant, Jones, Moyer, Cantwell, Locke, Inslee, H. Myers,  G. Fisher, Morris, Patrick, Miller, Wolfe, O'Brien, Rasmussen, Walk, May, Doty, Phillips, Betrozoff and Ballard)

Read first time 3/1/89 and referred to Committee on Appropriations.

AN ACT Relating to mammograms; adding a new section to chapter 48.20 RCW; adding a new section to chapter 48.21 RCW; adding a new section to chapter 48.44 RCW; adding a new section to chapter 48.46 RCW; and adding a new section to chapter 41.05 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1.  A new section is added to chapter 48.20 RCW to read as follows:

          Each disability insurance policy issued or renewed after January 1, 1990, that provides coverage for hospital or medical expenses shall provide coverage for screening or diagnostic mammography services, provided that such services are delivered upon the recommendation of the patient's physician.

          This section shall not be construed to prevent the application of standard policy provisions applicable to other benefits such as deductible or copayment provisions.  This section does not limit the authority of an insurer to negotiate rates and contract with specific providers for the delivery of mammography services.  This section shall not apply to medicare supplement policies.

NEW SECTION. Sec. 2.  A new section is added to chapter 48.21 RCW to read as follows:

          Each group disability insurance policy issued or renewed after January 1, 1990, that provides coverage for hospital or medical expenses shall provide coverage for screening or diagnostic mammography services, provided that such services are delivered upon the recommendation of the patient's physician.

          This section shall not be construed to prevent the application of standard policy provisions applicable to other benefits such as deductible or copayment provisions.  This section does not limit the authority of an insurer to negotiate rates and contract with specific providers for the delivery of mammography services.  This section shall not apply to medicare supplement policies.

NEW SECTION. Sec. 3.  A new section is added to chapter 48.44 RCW to read as follows:

          Each health care service contract issued or renewed after January 1, 1990, that provides benefits for hospital or medical care shall provide benefits for screening or diagnostic mammography services, provided that such services are delivered upon the recommendation of the patient's physician.

          This section shall not be construed to prevent the application of standard contract provisions applicable to other benefits such as deductible or copayment provisions.  This section does not limit the authority of a contractor to negotiate rates and contract with specific providers for the delivery of mammography services.  This section shall not apply to medicare supplement policies.

NEW SECTION. Sec. 4.  A new section is added to chapter 48.46 RCW to read as follows:

          Each health maintenance agreement issued or renewed after January 1, 1990, that provides benefits for hospital or medical care shall provide benefits for screening or diagnostic mammography services, provided that such services are delivered upon the recommendation of the patient's physician.

          All services must be provided by the health maintenance organization or rendered upon referral by the health maintenance organization.  This section shall not be construed to prevent the application of standard agreement provisions applicable to other benefits such as deductible or copayment provisions.  This section does not limit the authority of a health maintenance organization to negotiate rates and contract with specific providers for the delivery of mammography services.  This section shall not apply to medicare supplement policies.

NEW SECTION. Sec. 5.  A new section is added to chapter 41.05 RCW to read as follows:

          Each health plan offered to public employees and their covered dependents under this chapter that is not subject to the provisions of Title 48 RCW and is established or renewed after January 1, 1990, and that provides benefits for hospital or medical care shall provide benefits for screening or diagnostic mammography services, provided that such services are delivered upon the recommendation of the patient's physician.

          This section shall not be construed to prevent the application of standard health plan provisions applicable to other benefits such as deductible or copayment provisions.  This section does not limit the authority of the state health care authority to negotiate rates and contract with specific providers for the delivery of mammography services.  This section shall not apply to medicare supplement policies.