July 18 , 2008
Several Healthcare Legislative Proposals Become Law Since RI General Assembly Recessed on June 27
During the last week of the 2008 Rhode Island General Assembly Legislative Session, 18 bills were transmitted to the Governor for signature, of which 15 have become law, with or without the Governor’s signature. These new laws include:
Health Insurance Market Expansion
On July 1, H. 7493/S. 2286 were signed into law by Governor Carcieri.
This legislation amends the “Health Insurance Market Expansion Act” to allow a regional approach to health insurance that joins Rhode Island’s health insurance market with those of the other New England states. This legislation requires the Rhode Island Health Insurance Commissioner, on or before March 1, 2009, to complete a review of changes necessary to the laws and/or regulations in Rhode Island in order to meet the goal of enabling health insurers licensed in other New England states to do business in Rhode Island without going through the licensure process.
RIBGH Position: RIBGH supports this legislation, which would amend the Health Insurance Market Expansion Act and expand the opportunities for regional insurers to offer health insurance in Rhode Island. RIBGH believes that by opening up the Rhode island market through reciprocal licensure for health insurers already licensed to do business in other New England states, more flexible and affordable health care options would become available. This regional approach would increase the potential for plan innovation, choice, and competitiveness of insurance products that would help support businesses’ efforts to control cost while providing access to affordable quality health care.
Small Employer Health Insurance Availability Act
On June 26, S. 2680 was signed into law by Governor Carcieri. A companion bill, H. 7914, became effective on July 4 without the Governor’s signature.
This measure would allow small employer carriers to use employer group size as a rating factor.
RIBGH Position: RIBGH supports the use of consistently applied rating rules in community rating by insurance carriers. RIBGH supports this legislation, which would eliminate “health status” as an adjusted community rating factor in the development of community rates by small employer insurance carriers.
Healthy Rhode Island Reform Act of 2008
On June 30, S. 2484 became effective without the Governor’s signature. On July 5, a companion measure, H. 7352 became effective without the Governor’s signature.
An amended version of the Healthy Rhode Island Reform Act of 2008, this legislation would establish the Healthy Rhode Island Strategic Plan and Chronic Care Management Program. As part of this legislation, the Director of the Department of Health (DOH) in consultation with the Health Care Planning and Accountability Council, would be responsible for the development and implementation of a five-year strategic plan that charts the course for a healthy Rhode Island. The DOH Director would also be responsible for creating the criteria for the Healthy Rhode Island Chronic Care Management Program, as described in the Act.
RIBGH Position: RIBGH believes that addressing the problem of the uninsured in Rhode Island, improving health care quality and controlling costs requires the careful coordination of all stakeholders and a model that has built-in incentives to balance both quality and cost efficiencies. In 2007, RIBGH members participated in the development of enacted legislation that established the health care planning and accountability advisory council. H. 7352 Sub B and S. 2484 Sub B propose the utilization of this advisory council in the development of the Healthy Rhode Island Strategic Plan and Chronic Care Management Program for Rhode Island.
Health Care Quality Program
On July 3, H. 7465/S. 2481 became effective without the Governor’s signature.
The measure would create a healthcare quality and value database.
RIBGH Position: RIBGH supports evidence-based medicine initiatives that rely on the employer, payer, and provider to collect data on outcomes to support the most effective forms of care and to encourage their use through refinement of the benefit design. H. 7465 and S. 2481 would create the collection of such data needed for the development of evidence-based medicine and enhance the ability of Rhode Island consumers and employers to make informed and cost-effective health care choices.
The RI Health Information Exchange Act
On July 2, S. 2679 was signed into law by Governor Carcieri; the House version of this legislation, H. 7409, was signed by the Governor on July 10.
This legislation would establish safeguards and confidentiality protection for health information exchange.
RIBGH Position: RIBGH supports legislation that promotes greater transparency and access to information in the health care system. The Rhode Island Health Information Exchange will make available to health care consumers in Rhode Island transparent health care information necessary to empower them to better manage their own and their family’s healthcare. This legislation would make participation in the Health Information Exchange voluntary, allow consumers to obtain copies of their health care information in the Health Information Exchange and correct inaccurate records, while having the assurance that this technology will be used appropriately and confidentially.
Co-pay Cap for Ambulance Services
On June 25, H. 8014/S. 2800 became effective without the Governor’s signature.
The measure would provide a co-payment/deductible limit of $50 for licensed ambulance services, for every individual or group insurance contract, plan, or policy delivered or renewed in RI.
RIBGH Position: While RIBGH does not support health insurance mandates, this measure would establish a consistent practice by heath insurerers in the treatment of licensed ambulance services in insurance contracts.
Rhode Island Patient Safety & Quality Improvement Act
On July 1, H. 7561 was signed into law by the Governor.
This legislation promotes patient safety, reduction of medical errors, and encourages better reporting of medical errors and related incidents.
RIBGH Position: RIBGH supports legislation that promotes patient safety and better quality of health care.
Resolution Creating a Joint Legislative Task Force to Study Health Care Reform Proposals
On July 5, H. 7466 became effective without the Governor’s signature; the Senate version, S.2222 , became effective without the Governor’s signature on July 8.
The resolution would create a nine-member joint task force to make a comprehensive study of all aspects of proposed health care reform measures.
RIBGH Position: RIBGH supports efforts to continue the review and development of health care reform measures.
Health Insurance Hub Act of 2008 Needs Further Study
On March 11, House Corporations recommended H. 7910 be held for further study. On June 18, the Senate Health and Human Services Committee recommended S.2472 be held for further study.
The measure would create the Rhode Island Health Insurance Access Hub to facilitate the purchase of affordable health care to eligible persons and groups.
RIBGH Position: On June 13, RIBGH’s Legislative Affairs and Public Policy Committee sent letters of support to legislators and testified in March to urge its passage. RIBGH supports the creation of a structure, similar to the “Connector” in Massachusetts, which would allow individuals and small business to purchase affordable health insurance and allow insurers to make available innovative plans that focus on preventative care and chronic disease management. The Health Hub will fulfill two essential functions: setting policy for new, innovative and affordable health insurance coverage and creating the infrastructure to offer these new affordable plans directly to individuals and small businesses through a user-friendly online interface. Both of these steps will be necessary to make innovative, lower cost health insurance available in Rhode Island.
Uncollected Hospital Co-pay/Deductible Bill
Sent Back to Senate Finance
On June 17, the Senate voted to recommit S. 2414/H. 7057 to the Senate Finance Committee.
The measure would require health insurance carriers to reimburse hospitals for certain uncollected member co-payments and deductibles and place conditions upon the variation of adjusted community rates applied by small employer carriers.
RIBGH Position: While RIBGH supports legislation that contributes to lowering overall health care costs through improvement in the efficiency of the billing/collection process. this particular legislation is focused on small employer carriers assisting hospitals financially through reimbursement for uncollected bad debt. RIBGH has concerns that the cost of any such carrier reimbursement will be passed on to purchasers of health insurance through premium increases.
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