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2016 SESSION

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HB 87 Health Insurance Reform Commission; assessments of legislation.

Introduced by: Kathy J. Byron | all patrons    ...    notes | add to my profiles | history

SUMMARY AS PASSED HOUSE:

Health Insurance Reform Commission. Clarifies the applicable governmental agency that is tasked with determining whether a proposed mandated health insurance benefit exceeds the scope of the essential health benefits. The existing provision that gives this task to the Exchange is misplaced because the Exchange is a program, administered by the Centers for Medicare and Medicaid Services, through which health insurance is offered. If applicable federal rules require an agency of the Commonwealth to identify the state-mandated benefits that are in addition to the essential health benefits but do not identify a specific agency that is responsible for making such identification, the Bureau of Insurance shall be the applicable agency.

SUMMARY AS INTRODUCED:

Health Insurance Reform Commission. Clarifies that it is the Centers for Medicare and Medicaid Services (CMS) or other appropriate federal agency that determines whether a proposed mandated health insurance benefit or provider exceeds the scope of the essential health benefits. The existing reference to the Exchange, also known as the federally facilitated Health Insurance Marketplace, is misplaced because the Exchange is a program, administered by CMS, through which health insurance is offered.