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2002 SESSION

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SJ 77 Study; state employees health insurance.

Introduced by: Phillip P. Puckett | all patrons    ...    notes | add to my profiles

SUMMARY AS PASSED: (all summaries)

Services provided by out-of-network health care providers in certain Virginia localities. Requests the Department of Human Resource Management and the Secretary of Administration to study issues relating to services provided by out-of-network health care providers in certain localities. This resolution calls for an examination of (i) the availability of participating specialty physician and hospital care in rural or sparsely populated areas of the Commonwealth that are located on or near the state line; (ii) ways to resolve patients' financial concerns about accessing available specialty physician and hospital care, particularly, in rural Virginia areas with shortages of health care providers and in state-line jurisdictions; (iii) the feasibility of providing an exception from the pre-approval rule for special circumstances that do not rise to the level of a life-threatening emergency but are exigent medical necessities for patients living in localities near the state line; (iv) the feasibility of contracting with out-of-state physicians and hospitals that are located in close proximity to the Virginia state line; (v) the possibility of providing a grace period for pre-approval of out-of-network care in state-line jurisdictions under specific circumstances; and (vi) ways to improve patient knowledge and understanding of the out-of-network penalty and when it applies and physician awareness of the need for pre-approval for out-of-network care in terms of reimbursement levels. The Department and the Secretary must submit their report to the Governor and the 2003 Session of the General Assembly.


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