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1999 SESSION

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HB 699 Health insurance; coverage for hospice care.

Introduced by: Vincent F. Callahan, Jr. | all patrons    ...    notes | add to my profiles | history

SUMMARY AS PASSED HOUSE:

Accident and sickness insurance; coverage for hospice care. Requires health insurers, health maintenance organizations and corporations providing accident and sickness subscription contracts to provide coverage for hospice care. “Hospice care” means a coordinated program of home and inpatient care provided directly or under the direction of a licensed hospice and includes palliative and supportive physical, psychological, psychosocial and other health services to individuals with a terminal illness utilizing a medically directed interdisciplinary team. “Terminal illness” means a condition in an individual that has been diagnosed as terminal by a licensed physician, whose medical prognosis is death within six months, and who elect to receive palliative rather than curative care. The bill stipulates that documentation requirements for hospice coverage must be no greater than those required for the same services under Medicare. This bill does not prevent insurers, corporations, or health maintenance organizations from offering or providing coverage for hospice services where it cannot be demonstrated that the illness is terminal or that the individual’s life expectancy is longer than six months. The provisions of this bill do not apply to short-term travel, accident only short-term nonrenewable policies of not more than six months duration or to Medicare supplement policies.

SUMMARY AS INTRODUCED:

Accident and sickness insurance; coverage for hospice care. Requires health insurers, health maintenance organizations and corporations providing accident and sickness subscription contracts to provide coverage for hospice care. "Hospice care" means palliative medical care and related services as covered under Medicare, provided by a licensed hospice in accordance with a plan of care established and maintained by the treating hospice. "Terminal illness" means a condition in an individual that has been diagnosed as terminal by a licensed physician, whose medical prognosis is death within six months, and who elect to receive palliative rather than curative care. Reimbursement rates for hospice care must be no less than rates for the same services provided under Medicare and documentation requirements must not be greater than those required for the same services under Medicare. This bill does not prevent insurers, corporations, or health maintenance organizations from offering or providing coverage for hospice services, even if it cannot be demonstrated that the illness is terminal or that the individual's life expectancy is longer than six months. The provisions of this bill do not apply to short-term travel, accident only, limited or specified disease policies, or to short-term nonrenewable policies of not more than six months duration.