2097‑S AMH DYER HAGE 2

SHB 2097 ‑ H AMD 202 FAILED 2-13-96

By Representative Dyer

     On page 1, after line 3, insert the following:

     "Sec. 1.  RCW 48.43.045 and 1995 c 265 s 8 are each amended to read as follows:

(1)Effective January 1, 1996, every health plan delivered, issued for delivery, or renewed by a health carrier ((on and after January 1, 1996))in compliance with the model basic health plan benefits package, as required by RCW 70.47.060(2)(d),shall:

     (((1)))(a) Permit every category of health care provider to provide health services or care for conditions included in the model basic health plan ((services))benefits package, as required by RCW 70.47.060(2)(d),  to the extent that:

     (((a)))(i) The provision of such health services or care is within the health care providers' permitted scope of practice; and

     (((b)))(ii)  The providers agree to abide by standards related to:

     (((i)))(A) Provision, utilization review, and cost containment of health services;

     (((ii)))(B)  Management and administrative procedures; and

     (((iii)))(C) Provision of cost-effective and clinically efficacious health services.

     (2) Effective January 1, 1996, every health carrier shall annually report the names and addresses of all officers, directors, or trustees of the health carrier during the preceding year, and the amount of wages, expense reimbursements, or other payments to such individuals."

Renumber the remaining sections; correct all references and the title.

EFFECT:  Clarifies that the "Permit every category of health care provider" provision applies only to the benefits offered specifically with the model plan.