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First Substitute S.B. 204
Senator Peter C. Knudson proposes to substitute the following bill:
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STUDY OF HEALTH INSURANCE INDUSTRY
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2000 GENERAL SESSION
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STATE OF UTAH
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Sponsor: Peter C. Knudson
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AN ACT RELATING TO STATE COMMISSIONS AND COUNCILS; ADDING STUDY
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TOPICS FOR THE HEALTH POLICY COMMISSION.
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This act affects sections of Utah Code Annotated 1953 as follows:
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AMENDS:
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63C-3-104, as last amended by Chapter 21, Laws of Utah 1999
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Be it enacted by the Legislature of the state of Utah:
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Section 1.
Section
63C-3-104
is amended to read:
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63C-3-104. Duties of commission.
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The Health Policy Commission shall report to the Legislature and the governor on the
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following issues in accordance with Section
63C-3-101
:
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(1) (a) Each year, the commission may consider and make recommendations on the
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following:
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(i) federal health care reform and its impact on the state, including recommendations to
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respond to federal health initiatives;
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(ii) proposals for Medicaid reform and federal Medicaid waivers;
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(iii) evaluation of Medicare and its relationship to Utah's reform;
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(iv) impact of state initiatives on access, quality, and cost;
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(v) impact of market structure on competition;
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(vi) simplification of the administrative process;
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(vii) feasibility of establishing a statewide health information repository for the purpose
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of gathering statistical information about providers, practice parameters, cost, quality, and access,
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while protecting confidential information containing personal identifiers of patients from inclusion
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in any data base, except a data base created in accordance with Title 26, Chapter 33a, Utah Health
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Data Authority Act;
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(viii) review the need for, and revisions to benefit plans;
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(ix) the impact of federal and state health care reform on the viability of academic health
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centers in Utah; and
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(x) other issues that are discovered during the planning process.
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(b) The commission may change the order in which it considers and makes
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recommendations on the issues described in Subsections (2) through (8) and may consider other
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issues as it considers necessary to promote the purposes of this chapter.
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(2) By December 1, 1995:
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(a) advisability of, and if recommended, formation of a purchasing cooperative for
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individuals and employers with 50 or fewer employees, including structure, membership, costs,
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benefit plans, and health plan approval criteria;
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(b) impact of medical savings accounts in the health care market;
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(c) plan to address special population needs;
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(d) plan to continue the following insurance reform implementation and refinement:
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(i) systemwide community rating;
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(ii) portability;
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(iii) guaranteed issue; and
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(iv) risk adjustment mechanism;
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(e) continued development of the rural health plan, including the study and monitoring of
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the impact of managed health care plans in frontier areas of the state, and any consequences such
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plans have on the cost of medical care and access to health care providers in rural-frontier areas
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of the state;
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(f) continued development of cost/quality monitoring process; and
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(g) health care provider education reform emphasizing primary care and financing the
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health care provider education system.
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(3) By December 1, 1996:
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(a) alternatives to capitated reimbursement;
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(b) final recommendations for rural health plan; and
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(c) feasibility of including the following in a benefit plan:
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(i) alcohol and drug treatment;
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(ii) long-term care; and
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(iii) integrating workers' compensation and automobile/health insurance.
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(4) By December 1, 1997:
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(a) mental health care reform;
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(b) long-term care initiatives;
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(c) advisability of, and if recommended, formation of a purchasing cooperative for the
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public sector; and
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(d) advisability of rating health insurance premiums based on lifestyle choices that affect
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health care expenditures, including the consumption of alcohol or tobacco and other behaviors that
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increase health risks.
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(5) By December 1, 1998:
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(a) feasibility of including Medicaid in a purchasing cooperative;
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(b) continued development of mental health care reforms;
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(c) continued review of benefit plans; and
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(d) study and make recommendations on health care consumer education, information, and
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advocacy.
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(6) By December 1, 1999:
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(a) evaluate the purchasing cooperatives;
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(b) evaluate the advisability of expanding purchasing cooperative to employers with 50
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to 100 employees;
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(c) evaluate need for employer/individual mandates; and
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(d) evaluate future needs of or for the uninsurable risk pool.
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(7) By December 1, 2000[,]:
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(a) a comprehensive report and review on the implementation and effectiveness of the
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state's health care reform[.]; and
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(b) an evaluation of the state's health insurance industry to address the effectiveness of
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state insurance regulations, statutes, and rules in promoting a healthy, competitive health insurance
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industry, and recommendations to enhance the strength of the market, improve access, increase
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quality, and decrease costs.
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(8) The issues listed in this section are intended only to be study items for the commission.
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They do not represent a predetermined final outcome of that study. Any implementation of
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recommendations resulting from the study remain the prerogative of the Legislature.
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