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1994 SESSION

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HB 1057 Payments made for Medicaid.

Introduced by: Riley E. Ingram | all patrons    ...    notes | add to my profiles

SUMMARY:

Payments made for Medicaid. Conforms Virginia law to provisions of federal law as amended in § 13622 of the Omnibus Reconciliation Act of 1993 relating to recoupment of Medicaid payments from group health plans under a secondary payor provision. The bill: (i) prohibits insurers (including group health plans covered under the federal Employee Retirement Income Security Act of 1974 (ERISA)), health services plans, service benefit plans and health maintenance organizations from taking Medicaid status into account in enrolling an individual or in making payments for benefits; (ii) provides that the Commonwealth has a right to third-party payments to the extent that Medicaid has made payment for such items or services in cases where a third party has a legal liability to make payment for health care items or services; (iii) prohibits insurers, health services plans, and health maintenance organizations from denying enrollment of a child under the health coverage of the child's parent under enumerated circumstances; (iv) requires insurers, health services plans, and health maintenance organizations to permit a parent to enroll any child who is otherwise eligible for coverage under the parent's coverage in cases where a parent is required by court or administrative order to provide health coverage for a child and the parent is eligible for family health coverage; and (v) prohibits insurers, health maintenance organizations and health services plans from restricting coverage for adopted children solely because of a preexisting condition at the time that the child would otherwise become eligible for coverage.


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