Introduced Version
House Bill 2918 History
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Key: Green = existing Code. Red = new code to be enacted
H. B. 2918
(By Delegates Ferns, Manchin, Ferro, Sponaugle,
Sobonya and Storch)
[Introduced March 13, 2013; referred to the
Committee on Health and Human Resources then the
Judiciary.]
A BILL to repeal §33-4-7 of the Code of West Virginia, 1931, as
amended; to amend said code by adding thereto a new section,
designated §33-1-22; to amend and reenact §33-4-8 of said
code; to amend and reenact §33-15-4d and §33-15-14 of said
code; to amend said code by adding thereto a new section,
designated §33-15-22
; to amend and reenact §33-16-3h and
§33-16-10 of said code; to amend said code by adding thereto
a new section, designated §33-16-18; to amend said code by
adding thereto three new sections, designated §33-16D-17,
§33-16D-18 and §33-16D-19; to amend and reenact §33-24-7c and
§33-24-43 of said code; to amend said code by adding thereto
a new section, designated §33-24-7l; to amend and reenact
§33-25-8b of said code; to amend said code by adding thereto
a new section, designated §33-25-8i; to amend and reenact
§33-25-20; to amend and reenact §33-25A-8b of said code; to
amend said code by adding thereto a new section, designated §33-25A-8k; to amend and reenacted §33-25A-31 of said code;
and to amend said code by adding thereto two new sections,
designated §33-28-8 and §33-28-9, all relating to creating the
West Virginia Fair Health Insurance Act of 2013; defining
"illusionary benefit" to require benefits to cover at least
seventy-five percent of health care service; establishing
reasonable copays among common insurance needs; preventing
insurance companies from discriminating against licensed
health care practitioners to whom they will pay for a covered
service; preventing insurance companies from arbitrarily
defining medically necessary rehabilitation services to avoid
making payment for a covered service or for a service that
should be covered; making physical therapy and rehabilitation
services a mandated covered service for any health insurance
plan; and increasing the monetary criminal penalty for
insurance companies that violate any provisions of the
chapter.
Be it enacted by the Legislature of West Virginia:
That §33-4-7 of the Code of West Virginia, 1931, as amended,
be repealed; that said code be amended by adding thereto a new
section, designated §33-1-22; that §33-4-8 of said code be amended
and reenacted; that §33-15-4d and §33-15-14 of said code be amended
and reenacted; that said code be amended by adding thereto a new
section, designated §33-15-22; that §33-16-3h and §33-16-10 of said code be amended and reenacted; that said code be amended by adding
thereto a new section, designated §33-16-18; that said code be
amended by adding thereto three new sections, designated
§33-16D-17, §33-16D-18 and §33-16D-19; that §33-24-7c of said code
be amended and reenacted; that said code be amended by adding
thereto a new section, designated §33-24-7l; that §33-24-43 of said
code be amended and reenacted; that §33-25-8b of said code be
amended and reenacted; that said code be amended by adding thereto
a new section, designated §33-25-8i; that §33-25-20 of said code be
amended and reenacted; that §33-25A-8b of said code be amended and
reenacted; that said code be amended by adding thereto a new
section, designated §33-25A-8k; that §33-25A-31 of said code be
amended and reenacted; and that said code be amended by adding
thereto two new sections, designated §33-28-8 and §33-28-9, all to
read as follows:
ARTICLE 1. DEFINITIONS.
§33-1-22. Illusory benefit and policy.
_____"Illusory benefit" means a copayment, or coinsurance, or
codeductible, or combination thereof, outside of the annual
contract deductible, which exceeds twenty-five percent of the
contractual fee paid by an accident and sickness insurance company,
fraternal benefit society, nonprofit health service corporation,
nonprofit hospital service corporation, nonprofit medical service
corporation, prepaid health plan, dental care plan, vision care plan, pharmaceutical plan, health maintenance organization, and all
similar type organizations to the network provider for covered
services under the beneficiary's health insurance policy.
_____"Policy" means any policy, contract, plan or agreement of
accident and sickness insurance, and credit accident and sickness
insurance, delivered or issued for delivery in this state by any
company subject to this article; any certificate, contract or
policy issued by a fraternal benefit society; and any certificate
issued pursuant to a group insurance policy delivered or issued for
delivery in this state.
_____An insurer is prohibited from issuing policy that imposes an
illusory benefit on beneficiaries for services provided by any of
its network providers.
ARTICLE 4. GENERAL PROVISIONS.
§33-4-8. General penalty.
In addition to the refusal to renew, suspension or revocation
of a license, or penalty in lieu of the foregoing, because of
violation of any provision of this chapter, it is a misdemeanor for
any person to violate any provision of this chapter unless the
violation is declared to be a felony by this chapter or other law
of this state. Unless another penalty is provided in this chapter
or by the laws of this state, every person convicted of a
misdemeanor for the violation of any provision of this chapter
shall be fined not more less than $1,000 per occurrence nor more than §10,000 per occurrence or confined in jail not more than six
months, or both fined and confined.
ARTICLE 15. ACCIDENT AND SICKNESS INSURANCE.
§33-15-4d. Third party reimbursement for rehabilitation services.
(a) Notwithstanding any provision of any policy, provision,
contract, plan or agreement to which this article applies, any
entity regulated by this article shall, on or after July 1, 1991
2013, provide as benefits to all subscribers and members coverage
for rehabilitation services as hereinafter set forth, unless
rejected by the insured.
(b) Medically necessary rehabilitation services. --
Rehabilitation, as part of an individual's health care, is
considered medically necessary as determined by the qualified
health care provider based on the results of an evaluation and when
provided for the purpose of preventing, minimizing or eliminating
impairments, activity limitations or participation restrictions.
Rehabilitation services are delivered throughout the episode of
care by the qualified health care provider or under his or her
direction and supervision; requires the knowledge, clinical
judgment, and abilities of the qualified health care provider;
takes into consideration the potential benefits and harms to the
patient/client; and is not provided exclusively for the convenience
of the patient/client. Rehabilitation services are provided using
evidence of effectiveness and applicable standards of practice and is considered medically necessary if the type, amount and duration
of services outlined in the plan of care increase the likelihood of
meeting one or more of these stated goals: to improve function,
minimize loss of function, or decrease risk of injury and disease.
_____(b) (c) For purposes of this article and section,
"rehabilitation services" includes those services which are
designed to remediate patient's condition or restore patients to
their optimal physical, medical, psychological, social, emotional,
vocational and economic status. Rehabilitative services include by
illustration and not limitation diagnostic testing, assessment,
monitoring or treatment of the following conditions individually or
in a combination:
(1) Stroke;
(2) Spinal cord injury;
(3) Congenital deformity;
(4) Amputation;
(5) Major multiple trauma;
(6) Fracture of femur;
(7) Brain injury;
(8) Polyarthritis, including rheumatoid arthritis;
(9) Neurological disorders, including, but not limited to,
multiple sclerosis, motor neuron diseases, polyneuropathy, muscular
dystrophy and Parkinson's disease;
(10) Cardiac disorders, including, but not limited to, acute myocardial infarction, angina pectoris, coronary arterial
insufficiency, angioplasty, heart transplantation, chronic
arrhythmias, congestive heart failure, valvular heart disease;
(11) Burns;
(12) Orthopedic Disorders;
_____(13) Chronic Diseases including, but not limited to, diabetes,
hypertension and obesity;
_____(14) Fall prevention and treatment;.
(c) (d) Rehabilitative services includes care rendered by any
of the following:
(1) A hospital duly licensed by the State of West Virginia
that meets the requirements for rehabilitation hospitals as
described in Section 2803.2 of the Medicare Provider Reimbursement
Manual, Part 1, as published by the U.S. Health Care Financing
Administration;
(2) A distinct part rehabilitation unit in a hospital duly
licensed by the State of West Virginia. The distinct part unit
must meet the requirements of Section 2803.61 of the Medicare
Provider Reimbursement Manual, Part 1, as published by the U.S.
Health Care Financing Administration;
(3) A hospital duly licensed by the State of West Virginia
which meets the requirements for cardiac rehabilitation as
described in Section 35-25, Transmittal 41, dated August, 1989, as
promulgated by the U.S. Health Care Financing Administration.
(4) Physical Therapists, Occupational Therapists and Speech
Language Pathologists; (qualified health care professionals
currently authorized under federal law (42 C.F.R. § 484.4)
_____(d) (e) Rehabilitation services do not include services for
mental health, chemical dependency, vocational rehabilitation,
long-term maintenance or custodial services.
(e) (f) A policy, provision, contract, plan or agreement may
apply to rehabilitation services the same deductibles, coinsurance
and other limitations as apply to other covered services.
§33-15-14. Policies discriminating among health care providers.
Notwithstanding any other provisions of law, when any health
insurance policy, health care services plan or other contract
provides for the payment of medical expenses, benefits or
procedures, such the policy, plan or contract shall be construed to
include payment to all health care providers including, but not
limited to, medical physicians, osteopathic physicians, podiatric
physicians, chiropractic physicians, physical therapists,
occupational therapists, midwives, and nurse practitioners and
their licensed assistants, who provide medical services, benefits
or procedures which are within the scope of each respective
provider's license. Any limitation or condition placed upon
services, diagnoses or treatment by, or payment to any particular
type of licensed provider shall apply equally to all types of
licensed providers without unfair discrimination as to the usual and customary treatment procedures of any of the aforesaid
providers.
§33-15-22. Copayments and coinsurance.
_____"Copayment" means a specific dollar amount or percentage not
to exceed twenty-five percent of covered charges, except as
otherwise provided by statute, that the subscriber must pay upon
receipt of covered health care services and which is set at an
amount or percentage consistent with allowing subscriber access to
health care services.
_____(a) Copayments in health benefit plans may not exceed the
following amounts:
_____(1) Preventive services, $30;
_____(2) Primary care provider office visit, including physical,
occupational and speech therapists, $30;
_____(3) Specialist physician office visit, $75;
_____(4) Emergency room visit, $100;
_____(5) Outpatient surgery, $500;
_____(6) Inpatient admission, $500 per day up to a maximum of
$2,500 per admission;
_____(7) Magnetic resonance imaging, computerized axial tomography
and positron emission tomography, $100;
_____(8) For any other services and supplies, the copayment is to
be determined so that the carrier insures seventy-five percent or
more of the aggregate risk for the service or supply to which the copayment is applied.
_____(b) Network copayment may not be applied to any service or
supply to which network coinsurance is applied.
_____(c)"Family out-of-pocket limit" means the maximum dollar
amount that a family shall pay in combination as copayment,
deductible and coinsurance for network covered services and
supplies in a calendar, contract or policy year.
_____(d)"Individual out-of-pocket limit" means the maximum dollar
amount that a covered person shall pay as copayment, deductible and
coinsurance for services and supplies provided by network providers
in a calendar, contract or policy year.
_____(e)"Network coinsurance" means the percentage of the
contractual fee of the network provider for covered services and
supplies specified in the contract between the provider and the
carrier that must be paid by the covered person, under the health
benefit plan, subject to network deductible and network
out-of-pocket limit.
_____(f) All amounts paid as copayment, coinsurance and deductible
count toward the out-of-pocket limit, and may not be excluded
because of the nature of the service rendered, the illness or
condition being treated, or for any other reason, except carriers
may, provided the terms of the health benefit plan so state, elect
to exclude from the out-of-pocket limit the cost sharing associated
with prescription drug coverage, whether provided as part of the health benefit plan or as a rider.
ARTICLE 16. GROUP ACCIDENT AND SICKNESS INSURANCE.
§33-16-3h. Third party reimbursement for rehabilitation services.
(a) Notwithstanding any provision of any policy, provision,
contract, plan or agreement to which this article applies, any
entity regulated by this article shall, on or after July 1, 1991
2013, provide as benefits to all subscribers and members coverage
for rehabilitation services as hereinafter set forth, unless
rejected by the insured.
(b) Medically necessary rehabilitation services. --
Rehabilitation, as part of an individual's health care, is
considered medically necessary as determined by the qualified
health care provider based on the results of an evaluation and when
provided for the purpose of preventing, minimizing or eliminating
impairments, activity limitations or participation restrictions.
Rehabilitation services are delivered throughout the episode of
care by the qualified health care provider or under his or her
direction and supervision; requires the knowledge, clinical
judgment, and abilities of the qualified health care provider;
takes into consideration the potential benefits and harms to the
patient/client; and is not provided exclusively for the convenience
of the patient/client. Rehabilitation services are provided using
evidence of effectiveness and applicable standards of practice and
is considered medically necessary if the type, amount and duration of services outlined in the plan of care increase the likelihood of
meeting one or more of these stated goals: to improve function,
minimize loss of function, or decrease risk of injury and disease.
_____(b) (c) For purposes of this article and section,
"rehabilitation services" includes those services which are
designed to remediate patient's condition or restore patients to
their optimal physical, medical, psychological, social, emotional,
vocational and economic status. Rehabilitative services include by
illustration and not limitation diagnostic testing, assessment,
monitoring or treatment of the following conditions individually or
in a combination:
(1) Stroke;
(2) Spinal cord injury;
(3) Congenital deformity;
(4) Amputation;
(5) Major multiple trauma;
(6) Fracture of femur;
(7) Brain injury;
(8) Polyarthritis, including rheumatoid arthritis;
(9) Neurological disorders, including, but not limited to,
multiple sclerosis, motor neuron diseases, polyneuropathy, muscular
dystrophy and Parkinson's disease;
(10) Cardiac disorders, including, but not limited to, acute
myocardial infarction, angina pectoris, coronary arterial insufficiency, angioplasty, heart transplantation, chronic
arrhythmias, congestive heart failure, valvular heart disease;
(11) Burns;
(12) Orthopedic Disorders;
_____(13) Chronic Diseases including, but not limited to, diabetes,
hypertension and obesity;
_____(14) Fall prevention and treatment;
_____(c) (d) Rehabilitative services includes care rendered by any
of the following:
(1) A hospital duly licensed by the State of West Virginia
that meets the requirements for rehabilitation hospitals as
described in Section 2803.2 of the Medicare Provider Reimbursement
Manual, Part 1, as published by the U.S. Health Care Financing
Administration;
(2) A distinct part rehabilitation unit in a hospital duly
licensed by the State of West Virginia. The distinct part unit
must meet the requirements of Section 2803.61 of the Medicare
Provider Reimbursement Manual, Part 1, as published by the U.S.
Health Care Financing Administration;
(3) A hospital duly licensed by the State of West Virginia
which meets the requirements for cardiac rehabilitation as
described in Section 35-25, Transmittal 41, dated August, 1989, as
promulgated by the U.S. Health Care Financing Administration.
(4) Physical Therapists, Occupational Therapists and Speech Language Pathologists; (qualified health care professionals
currently authorized under federal law (42 C.F.R. § 484.4)
_____(d) (e) Rehabilitation services do not include services for
mental health, chemical dependency, vocational rehabilitation,
long-term maintenance or custodial services.
(e) (f) A policy, provision, contract, plan or agreement may
apply to rehabilitation services the same deductibles, coinsurance
and other limitations as apply to other covered services.
§33-16-10. Policies discriminating among health care providers.
Notwithstanding any other provisions of law, when any health
insurance policy, health care services plan or other contract
provides for the payment of medical expenses, benefits or
procedures, such the policy, plan or contract shall be construed to
include payment to all health care providers including , but not
limited to, medical physicians, osteopathic physicians, podiatric
physicians, chiropractic physicians, physical therapists,
occupational therapists, midwives, and nurse practitioners and
their licensed assistants, who provide medical services, benefits
or procedures which are within the scope of each respective
provider's license. Any limitation or condition placed upon
services, diagnoses or treatment by, or payment to any particular
type of licensed provider shall apply equally to all types of
licensed providers without unfair discrimination as to the usual
and customary treatment procedures of any of the aforesaid providers.
§33-16-18. Copayments and coinsurance.
_____"Copayment" means a specific dollar amount or percentage not
to exceed twenty-five percent of covered charges, except as
otherwise provided by statute, that the subscriber must pay upon
receipt of covered health care services and which is set at an
amount or percentage consistent with allowing subscriber access to
health care services.
_____(a) Copayments in health benefit plans may not exceed the
following amounts:
_____(1) Preventive services, $30;
_____(2) Primary care provider office visit, including physical,
occupational and speech therapists, $30;
_____(3) Specialist physician office visit, $75;
_____(4) Emergency room visit, $100;
_____(5) Outpatient surgery, $500;
_____(6) Inpatient admission, $500 per day up to a maximum of
$2,500 per admission;
_____(7) Magnetic resonance imaging, computerized axial tomography
and positron emission tomography, $100;
_____(8) For any other services and supplies, the copayment is to
be determined so that the carrier insures seventy-five percent or
more of the aggregate risk for the service or supply to which the
copayment is applied.
_____(b) Network copayment may not be applied to any service or
supply to which network coinsurance is applied.
_____(c)"Family out-of-pocket limit" means the maximum dollar
amount that a family shall pay in combination as copayment,
deductible and coinsurance for network covered services and
supplies in a calendar, contract or policy year.
_____(d)"Individual out-of-pocket limit" means the maximum dollar
amount that a covered person shall pay as copayment, deductible and
coinsurance for services and supplies provided by network providers
in a calendar, contract or policy year.
_____(e)"Network coinsurance" means the percentage of the
contractual fee of the network provider for covered services and
supplies specified in the contract between the provider and the
carrier that must be paid by the covered person, under the health
benefit plan, subject to network deductible and network
out-of-pocket limit.
_____(f) All amounts paid as copayment, coinsurance and deductible
count toward the out-of-pocket limit, and may not be excluded
because of the nature of the service rendered, the illness or
condition being treated, or for any other reason, except carriers
may, provided the terms of the health benefit plan so state, elect
to exclude from the out-of-pocket limit the cost sharing associated
with prescription drug coverage, whether provided as part of the
health benefit plan or as a rider.
ARTICLE 16D. MARKETING AND RATE PRACTICES FOR SMALL EMPLOYER
ACCIDENT AND SICKNESS INSURANCE POLICIES.
§33-16D-17. Copayments and coinsurance.
_____"Copayment" means a specific dollar amount or percentage not
to exceed twenty-five percent of covered charges, except as
otherwise provided by statute, that the subscriber must pay upon
receipt of covered health care services and which is set at an
amount or percentage consistent with allowing subscriber access to
health care services.
_____(a) Copayments in health benefit plans may not exceed the
following amounts:
_____(1) Preventive services, $30;
_____(2) Primary care provider office visit, including physical,
occupational and speech therapists, $30;
_____(3) Specialist physician office visit, $75;
_____(4) Emergency room visit, $100;
_____(5) Outpatient surgery, $500;
_____(6) Inpatient admission, $500 per day up to a maximum of
§2,500 per admission;
_____(7) Magnetic resonance imaging, computerized axial tomography
and positron emission tomography, $100;
_____(8) For any other services and supplies, the copayment is to
be determined so that the carrier insures seventy-five percent or
more of the aggregate risk for the service or supply to which the copayment is applied.
_____(b) Network copayment may not be applied to any service or
supply to which network coinsurance is applied.
_____(c)"Family out-of-pocket limit" means the maximum dollar
amount that a family shall pay in combination as copayment,
deductible and coinsurance for network covered services and
supplies in a calendar, contract or policy year.
_____(d)"Individual out-of-pocket limit" means the maximum dollar
amount that a covered person shall pay as copayment, deductible and
coinsurance for services and supplies provided by network providers
in a calendar, contract or policy year.
_____(e)"Network coinsurance" means the percentage of the
contractual fee of the network provider for covered services and
supplies specified in the contract between the provider and the
carrier that must be paid by the covered person, under the health
benefit plan, subject to network deductible and network
out-of-pocket limit.
_____(f) All amounts paid as copayment, coinsurance and deductible
count toward the out-of-pocket limit, and may not be excluded
because of the nature of the service rendered, the illness or
condition being treated, or for any other reason, except carriers
may, provided the terms of the health benefit plan so state, elect
to exclude from the out-of-pocket limit the cost sharing associated
with prescription drug coverage, whether provided as part of the health benefit plan or as a rider.
§33-16D-18. Policies discriminating among health care providers.
____________________________________________Notwithstanding any other provisions of law, when any health
insurance policy, health care services plan or other contract
provides for the payment of medical expenses, benefits or
procedures, the policy, plan or contract shall be construed to
include payment to all health care providers including, but not
limited to, medical physicians, osteopathic physicians, podiatric
physicians, chiropractic physicians, physical therapists,
occupational therapists, midwives, nurse practitioners and their
licensed assistants, who provide medical services, benefits or
procedures which are within the scope of each respective provider's
license. Any limitation or condition placed on services, diagnoses
or treatment by, or payment to any particular type of licensed
provider shall apply equally to all types of licensed providers
without unfair discrimination as to the usual and customary
treatment procedures of any of the aforesaid providers.
§33-16D-19. Third party reimbursement for rehabilitation services.
____________________________________________(a) Notwithstanding any provision of any policy, provision,
contract, plan or agreement to which this article applies, any
entity regulated by this article shall, on or after July 1, 2013,
provide as benefits to all subscribers and members coverage for
rehabilitation services as hereinafter set forth, unless rejected
by the insured.
____________________________________________(b) Medically necessary rehabilitation services. --
Rehabilitation, as part of an individual's health care, is
considered medically necessary as determined by the qualified
health care provider based on the results of an evaluation and when
provided for the purpose of preventing, minimizing or eliminating
impairments, activity limitations or participation restrictions.
Rehabilitation services are delivered throughout the episode of
care by the qualified health care provider or under his or her
direction and supervision; requires the knowledge, clinical
judgment, and abilities of the qualified health care provider;
takes into consideration the potential benefits and harms to the
patient/client; and is not provided exclusively for the convenience
of the patient/client. Rehabilitation services are provided using
evidence of effectiveness and applicable standards of practice and
is considered medically necessary if the type, amount and duration
of services outlined in the plan of care increase the likelihood of
meeting one or more of these stated goals: to improve function,
minimize loss of function, or decrease risk of injury and disease.
____________________________________________(c) For purposes of this article and section, "rehabilitation
services" includes those services which are designed to remediate
patient's condition or restore patients to their optimal physical,
medical, psychological, social, emotional, vocational and economic
status. Rehabilitative services include by illustration and not
limitation diagnostic testing, assessment, monitoring or treatment of the following conditions individually or in a combination:
____________________________________________(1) Stroke;
____________________________________________(2) Spinal cord injury;
____________________________________________(3) Congenital deformity;
____________________________________________(4) Amputation;
____________________________________________(5) Major multiple trauma;
____________________________________________(6) Fracture of femur;
____________________________________________(7) Brain injury;
____________________________________________(8) Polyarthritis, including rheumatoid arthritis;
____________________________________________(9) Neurological disorders, including, but not limited to,
multiple sclerosis, motor neuron diseases, polyneuropathy, muscular
dystrophy and Parkinson's disease;
____________________________________________(10) Cardiac disorders, including, but not limited to, acute
myocardial infarction, angina pectoris, coronary arterial
insufficiency, angioplasty, heart transplantation, chronic
arrhythmias, congestive heart failure and valvular heart disease;
____________________________________________(11) Burns;
____________________________________________(12) Orthopedic Disorders;
____________________________________________(13) Chronic Diseases including, but not limited to, diabetes,
hypertension and obesity;
____________________________________________(14) Fall prevention and treatment;
____________________________________________(d) Rehabilitative services includes care rendered by any of
the following:
____________________________________________(1) A hospital duly licensed by the State of West Virginia that meets the requirements for rehabilitation hospitals as
described in Section 2803.2 of the Medicare Provider Reimbursement
Manual, Part 1, as published by the U.S. Health Care Financing
Administration;
____________________________________________(2) A distinct part rehabilitation unit in a hospital duly
licensed by the State of West Virginia. The distinct part unit
must meet the requirements of Section 2803.61 of the Medicare
Provider Reimbursement Manual, Part 1, as published by the U.S.
Health Care Financing Administration;
____________________________________________(3) A hospital duly licensed by the State of West Virginia
which meets the requirements for cardiac rehabilitation as
described in Section 35-25, Transmittal 41, dated August, 1989, as
promulgated by the U.S. Health Care Financing Administration.
____________________________________________(4) Physical Therapists, Occupational Therapists and Speech
Language Pathologists; (qualified health care professionals
currently authorized under federal law (42 C.F.R. § 484.4)
____________________________________________(e) Rehabilitation services do not include services for mental
health, chemical dependency, vocational rehabilitation, long-term
maintenance or custodial services.
____________________________________________(f) A policy, provision, contract, plan or agreement shall
apply to rehabilitation services the same deductibles, coinsurance
and other limitations as apply to other covered services.
ARTICLE 24. HOSPITAL SERVICE CORPORATIONS, MEDICAL SERVICE
CORPORATIONS, DENTAL SERVICE CORPORATIONS AND HEALTH SERVICE CORPORATIONS.
§33-24-7c. Third party reimbursement for rehabilitation services.
(a) Notwithstanding any provision of any policy, provision,
contract, plan or agreement to which this article applies, any
entity regulated by this article shall, on or after July 1, 1991
2013, provide as benefits to all subscribers and members coverage
for rehabilitation services as hereinafter set forth, unless
rejected by the insured.
(b) Medically necessary rehabilitation services. --
Rehabilitation, as part of an individual's health care, is
considered medically necessary as determined by the qualified
health care provider based on the results of an evaluation and when
provided for the purpose of preventing, minimizing or eliminating
impairments, activity limitations or participation restrictions.
Rehabilitation services are delivered throughout the episode of
care by the qualified health care provider or under his or her
direction and supervision; requires the knowledge, clinical
judgment, and abilities of the qualified health care provider;
takes into consideration the potential benefits and harms to the
patient/client; and is not provided exclusively for the convenience
of the patient/client. Rehabilitation services are provided using
evidence of effectiveness and applicable standards of practice and
is considered medically necessary if the type, amount and duration
of services outlined in the plan of care increase the likelihood of meeting one or more of these stated goals: to improve function,
minimize loss of function, or decrease risk of injury and disease.
____________________________________________(b) (c) For purposes of this article and section,
"rehabilitation services" includes those services which are
designed to remediate patient's condition or restore patients to
their optimal physical, medical, psychological, social, emotional,
vocational and economic status. Rehabilitative services include by
illustration and not limitation diagnostic testing, assessment,
monitoring or treatment of the following conditions individually or
in a combination:
(1) Stroke;
(2) Spinal cord injury;
(3) Congenital deformity;
(4) Amputation;
(5) Major multiple trauma;
(6) Fracture of femur;
(7) Brain injury;
(8) Polyarthritis, including rheumatoid arthritis;
(9) Neurological disorders, including, but not limited to,
multiple sclerosis, motor neuron diseases, polyneuropathy, muscular
dystrophy and Parkinson's disease;
(10) Cardiac disorders, including, but not limited to, acute
myocardial infarction, angina pectoris, coronary arterial
insufficiency, angioplasty, heart transplantation, chronic arrhythmias, congestive heart failure, valvular heart disease;
(11) Burns;
(12) Orthopedic Disorders;
____________________________________________(13) Chronic Diseases including, but not limited to, diabetes,
hypertension, and obesity;
____________________________________________(14) Fall prevention and treatment
.
(c) (d) Rehabilitative services includes care rendered by any
of the following:
(1) A hospital duly licensed by the State of West Virginia
that meets the requirements for rehabilitation hospitals as
described in Section 2803.2 of the Medicare Provider Reimbursement
Manual, Part 1, as published by the U.S. Health Care Financing
Administration;
(2) A distinct part rehabilitation unit in a hospital duly
licensed by the State of West Virginia. The distinct part unit
must meet the requirements of Section 2803.61 of the Medicare
Provider Reimbursement Manual, Part 1, as published by the U.S.
Health Care Financing Administration;
(3) A hospital duly licensed by the State of West Virginia
which meets the requirements for cardiac rehabilitation as
described in Section 35-25, Transmittal 41, dated August, 1989, as
promulgated by the U.S. Health Care Financing Administration.
(4) Physical Therapists, Occupational Therapists and Speech
Language Pathologists; (qualified health care professionals currently authorized under federal law (42 C.F.R. § 484.4)
____________________________________________(d) (e) Rehabilitation services do not include services for
mental health, chemical dependency, vocational rehabilitation,
long-term maintenance or custodial services.
(e) (f) A policy, provision, contract, plan or agreement may
apply to rehabilitation services the same deductibles, coinsurance
and other limitations as apply to other covered services.
§33-24-7l. Copayments and coinsurance.
____________________________________________"Copayment" means a specific dollar amount or percentage not
to exceed twenty-five percent of covered charges, except as
otherwise provided for by statute, that the subscriber must pay
upon receipt of covered health care services and which is set at an
amount or percentage consistent with allowing subscriber access to
health care services.
____________________________________________(a) Copayments in health benefit plans may not exceed the
following amounts:
____________________________________________(1) Preventive services, $30;
____________________________________________(2) Primary care provider office visit, including physical,
occupational and speech therapists, $30;
____________________________________________(3) Specialist physician office visit, $75;
____________________________________________(4) Emergency room visit, $100;
____________________________________________(5) Outpatient surgery, $500;
____________________________________________(6) Inpatient admission, $500 per day up to a maximum of
§2,500 per admission;
____________________________________________(7) Magnetic resonance imaging, computerized axial tomography
and positron emission tomography, $100;
____________________________________________(8) For any other services and supplies, the copayment is to
be determined so that the carrier insures seventy-five percent or
more of the aggregate risk for the service or supply to which the
copayment is applied.
____________________________________________(b) Network copayment may not be applied to any service or
supply to which network coinsurance is applied.
____________________________________________(c)"Family out-of-pocket limit" means the maximum dollar
amount that a family shall pay in combination as copayment,
deductible and coinsurance for network covered services and
supplies in a calendar, contract or policy year.
____________________________________________(d)"Individual out-of-pocket limit" means the maximum dollar
amount that a covered person shall pay as copayment, deductible and
coinsurance for services and supplies provided by network providers
in a calendar, contract or policy year.
____________________________________________(e)"Network coinsurance" means the percentage of the
contractual fee of the network provider for covered services and
supplies specified in the contract between the provider and the
carrier that must be paid by the covered person, under the health
benefit plan, subject to network deductible and network
out-of-pocket limit.
____________________________________________(f) All amounts paid as copayment, coinsurance and deductible
count toward the out-of-pocket limit, and may not be excluded because of the nature of the service rendered, the illness or
condition being treated, or for any other reason, except carriers
may, provided the terms of the health benefit plan so state, elect
to exclude from the out-of-pocket limit the cost sharing associated
with prescription drug coverage, whether provided as part of the
health benefit plan or as a rider.
§33-24-43. Policies discriminating among health care providers.
Notwithstanding any other provisions of law, when any health
insurance policy, health care services plan or other contract
provides for the payment of medical expenses, benefits or
procedures, such the policy, plan or contract shall be construed to
include payment to all health care providers including, but not
limited to, medical physicians, osteopathic physicians, podiatric
physicians, chiropractic physicians, physical therapists,
occupational therapists, midwives, and nurse practitioners and
their licensed assistants, who provide medical services, benefits
or procedures which are within the scope of each respective
provider's license. Any limitation or condition placed upon
services, diagnoses or treatment by, or payment to any particular
type of licensed provider shall apply equally to all types of
licensed providers without unfair discrimination as to the usual
and customary treatment procedures of any of the aforesaid
providers.
ARTICLE 25. HEALTH CARE CORPORATIONS.
§33-25-8b. Third party reimbursement for rehabilitation services.
(a) Notwithstanding any provision of any policy, provision,
contract, plan or agreement to which this article applies, any
entity regulated by this article shall, on or after July 1, 1991
2013, provide as benefits to all subscribers and members coverage
for rehabilitation services as hereinafter set forth, unless
rejected by the insured.
(b) Medically necessary rehabilitation services. --
Rehabilitation, as part of an individual's health care, is
considered medically necessary as determined by the qualified
health care provider based on the results of an evaluation and when
provided for the purpose of preventing, minimizing or eliminating
impairments, activity limitations or participation restrictions.
Rehabilitation services are delivered throughout the episode of
care by the qualified health care provider or under his or her
direction and supervision; requires the knowledge, clinical
judgment and abilities of the qualified health care provider; takes
into consideration the potential benefits and harms to the
patient/client; and is not provided exclusively for the convenience
of the patient/client. Rehabilitation services are provided using
evidence of effectiveness and applicable standards of practice and
is considered medically necessary if the type, amount and duration
of services outlined in the plan of care increase the likelihood of
meeting one or more of these stated goals: to improve function, minimize loss of function, or decrease risk of injury and disease.
_____(b) (c) For purposes of this article and section,
"rehabilitation services" includes those services which are
designed to remediate patient's condition or restore patients to
their optimal physical, medical, psychological, social, emotional,
vocational and economic status. Rehabilitative services include by
illustration and not limitation diagnostic testing, assessment,
monitoring or treatment of the following conditions individually or
in a combination:
(1) Stroke;
(2) Spinal cord injury;
(3) Congenital deformity;
(4) Amputation;
(5) Major multiple trauma;
(6) Fracture of femur;
(7) Brain injury;
(8) Polyarthritis, including rheumatoid arthritis;
(9) Neurological disorders, including, but not limited to,
multiple sclerosis, motor neuron diseases, polyneuropathy, muscular
dystrophy and Parkinson's disease;
(10) Cardiac disorders, including, but not limited to, acute
myocardial infarction, angina pectoris, coronary arterial
insufficiency, angioplasty, heart transplantation, chronic
arrhythmias, congestive heart failure, valvular heart disease;
(11) Burns;
(12) Orthopedic Disorders;
_____(13) Chronic Diseases including, but not limited to, diabetes,
hypertension and obesity;
_____(14) Fall prevention and treatment;
_____(c) (d) Rehabilitative services includes care rendered by any
of the following:
(1) A hospital duly licensed by the State of West Virginia
that meets the requirements for rehabilitation hospitals as
described in Section 2803.2 of the Medicare Provider Reimbursement
Manual, Part 1, as published by the U.S. Health Care Financing
Administration;
(2) A distinct part rehabilitation unit in a hospital duly
licensed by the State of West Virginia. The distinct part unit
must meet the requirements of Section 2803.61 of the Medicare
Provider Reimbursement Manual, Part 1, as published by the U.S.
Health Care Financing Administration;
(3) A hospital duly licensed by the State of West Virginia
which meets the requirements for cardiac rehabilitation as
described in Section 35-25, Transmittal 41, dated August, 1989, as
promulgated by the U.S. Health Care Financing Administration.
(4) Physical Therapists, Occupational Therapists and Speech
Language Pathologists; (qualified health care professionals
currently authorized under federal law (42 C.F.R. § 484.4)
_____(d) (e) Rehabilitation services do not include services for
mental health, chemical dependency, vocational rehabilitation,
long-term maintenance or custodial services.
(e) (f) A policy, provision, contract, plan or agreement may
apply to rehabilitation services the same deductibles, coinsurance
and other limitations as apply to other covered services.
§33-25-8i. Copayments and coinsurance.
_____"Copayment" means a specific dollar amount or percentage not
to exceed twenty-five percent of covered charges, except as
otherwise provided by statute, that the subscriber must pay upon
receipt of covered health care services and which is set at an
amount or percentage consistent with allowing subscriber access to
health care services.
_____(a) Copayments in health benefit plans may not exceed the
following amounts:
_____(1) Preventive services, $30;
_____(2) Primary care provider office visit, including physical,
occupational and speech therapists, $30;
_____(3) Specialist physician office visit, $75;
_____(4) Emergency room visit, $100;
_____(5) Outpatient surgery, $500;
_____(6) Inpatient admission, $500 per day up to a maximum of
§2,500 per admission;
_____(7) Magnetic resonance imaging, computerized axial tomography and positron emission tomography, $100;
_____(8) For any other services and supplies, the copayment is to
be determined so that the carrier insures seventy-five percent or
more of the aggregate risk for the service or supply to which the
copayment is applied.
_____(b) Network copayment may not be applied to any service or
supply to which network coinsurance is applied.
_____(c)"Family out-of-pocket limit" means the maximum dollar
amount that a family shall pay in combination as copayment,
deductible and coinsurance for network covered services and
supplies in a calendar, contract or policy year.
_____(d)"Individual out-of-pocket limit" means the maximum dollar
amount that a covered person shall pay as copayment, deductible and
coinsurance for services and supplies provided by network providers
in a calendar, contract or policy year.
_____(e)"Network coinsurance" means the percentage of the
contractual fee of the network provider for covered services and
supplies specified in the contract between the provider and the
carrier that must be paid by the covered person, under the health
benefit plan, subject to network deductible and network
out-of-pocket limit.
_____(f) All amounts paid as copayment, coinsurance and deductible
count toward the out-of-pocket limit, and may not be excluded
because of the nature of the service rendered, the illness or condition being treated, or for any other reason, except carriers
may, provided the terms of the health benefit plan so state, elect
to exclude from the out-of-pocket limit the cost sharing associated
with prescription drug coverage, whether provided as part of the
health benefit plan or as a rider.
§33-25-20. Policies discriminating among health care providers.
Notwithstanding any other provisions of law, when any health
insurance policy, health care services plan or other contract
provides for the payment of medical expenses, benefits or
procedures, such the policy, plan or contract shall be construed to
include payment to all health care providers including, but not
limited to, medical physicians, osteopathic physicians, podiatric
physicians, chiropractic physicians, physical therapists,
occupational therapists, midwives, and nurse practitioners and
their licensed assistants, who provide medical services, benefits
or procedures which are within the scope of each respective
provider's license. Any limitation or condition placed upon
services, diagnoses or treatment by, or payment to any particular
type of licensed provider shall apply equally to all types of
licensed providers without unfair discrimination as to the usual
and customary treatment procedures of any of the aforesaid
providers.
ARTICLE 25A. HEALTH MAINTENANCE ORGANIZATION ACT.
§33-25A-8b. Third party reimbursement for rehabilitation services.
(a) Notwithstanding any provision of any policy, provision,
contract, plan or agreement to which this article applies, any
entity regulated by this article shall, on or after July 1, 1991
2013, provide as benefits to all subscribers and members coverage
for rehabilitation services as hereinafter set forth, unless
rejected by the insured.
(b) Medically necessary rehabilitation services. --
Rehabilitation, as part of an individual's health care, is
considered medically necessary as determined by the qualified
health care provider based on the results of an evaluation and when
provided for the purpose of preventing, minimizing or eliminating
impairments, activity limitations or participation restrictions.
Rehabilitation services are delivered throughout the episode of
care by the qualified health care provider or under his or her
direction and supervision; requires the knowledge, clinical
judgment, and abilities of the qualified health care provider;
takes into consideration the potential benefits and harms to the
patient/client; and is not provided exclusively for the convenience
of the patient/client. Rehabilitation services are provided using
evidence of effectiveness and applicable standards of practice and
is considered medically necessary if the type, amount and duration
of services outlined in the plan of care increase the likelihood of
meeting one or more of these stated goals: to improve function, minimize loss of function, or decrease risk of injury and disease.
____________________________________________(b) (c) For purposes of this article and section,
"rehabilitation services" includes those services which are
designed to remediate patient's condition or restore patients to
their optimal physical, medical, psychological, social, emotional,
vocational and economic status. Rehabilitative services include by
illustration and not limitation diagnostic testing, assessment,
monitoring or treatment of the following conditions individually or
in a combination:
(1) Stroke;
(2) Spinal cord injury;
(3) Congenital deformity;
(4) Amputation;
(5) Major multiple trauma;
(6) Fracture of femur;
(7) Brain injury;
(8) Polyarthritis, including rheumatoid arthritis;
(9) Neurological disorders, including, but not limited to,
multiple sclerosis, motor neuron diseases, polyneuropathy, muscular
dystrophy and Parkinson's disease;
(10) Cardiac disorders, including, but not limited to, acute
myocardial infarction, angina pectoris, coronary arterial
insufficiency, angioplasty, heart transplantation, chronic
arrhythmias, congestive heart failure, valvular heart disease;
(11) Burns;
(12) Orthopedic Disorders;
____________________________________________(13) Chronic Diseases including, but not limited to, diabetes,
hypertension and obesity;
____________________________________________(14) Fall prevention and treatment;
____________________________________________(c) (d) Rehabilitative services includes care rendered by any
of the following:
(1) A hospital duly licensed by the State of West Virginia
that meets the requirements for rehabilitation hospitals as
described in Section 2803.2 of the Medicare Provider Reimbursement
Manual, Part 1, as published by the U.S. Health Care Financing
Administration;
(2) A distinct part rehabilitation unit in a hospital duly
licensed by the State of West Virginia. The distinct part unit
must meet the requirements of Section 2803.61 of the Medicare
Provider Reimbursement Manual, Part 1, as published by the U.S.
Health Care Financing Administration;
(3) A hospital duly licensed by the State of West Virginia
which meets the requirements for cardiac rehabilitation as
described in Section 35-25, Transmittal 41, dated August, 1989, as
promulgated by the U.S. Health Care Financing Administration.
(4) Physical Therapists, Occupational Therapists and Speech
Language Pathologists; (qualified health care professionals
currently authorized under federal law (42 C.F.R. § 484.4)
____________________________________________(d) (e) Rehabilitation services do not include services for
mental health, chemical dependency, vocational rehabilitation,
long-term maintenance or custodial services.
(e) (f) A policy, provision, contract, plan or agreement may
apply to rehabilitation services the same deductibles, coinsurance
and other limitations as apply to other covered services.
§33-25A-8k. Copayments and coinsurance.
_____"Copayment" means a specific dollar amount or percentage not
to exceed twenty-five percent of covered charges, except as
otherwise provided for by statute, that the subscriber must pay
upon receipt of covered health care services and which is set at an
amount or percentage consistent with allowing subscriber access to
health care services.
_____(a) Copayments in health benefit plans may not exceed the
following amounts:
_____(1) Preventive services, $30;
_____(2) Primary care provider office visit, including physical,
occupational and speech therapists, $30;
_____(3) Specialist physician office visit, $75;
_____(4) Emergency room visit, $100;
_____(5) Outpatient surgery, $500;
_____(6) Inpatient admission, $500 per day up to a maximum of
$2,500 per admission;
_____(7) Magnetic resonance imaging, computerized axial tomography and positron emission tomography, $100;
_____(8) For any other services and supplies, the copayment is to
be determined so that the carrier insures seventy-five percent or
more of the aggregate risk for the service or supply to which the
copayment is applied.
_____(b) Network copayment may not be applied to any service or
supply to which network coinsurance is applied.
_____(c) "Family out-of-pocket limit" means the maximum dollar
amount that a family shall pay in combination as copayment,
deductible and coinsurance for network covered services and
supplies in a calendar, contract or policy year.
_____(d) "Individual out-of-pocket limit" means the maximum dollar
amount that a covered person shall pay as copayment, deductible and
coinsurance for services and supplies provided by network providers
in a calendar, contract or policy year.
_____(e) "Network coinsurance" means the percentage of the
contractual fee of the network provider for covered services and
supplies specified in the contract between the provider and the
carrier that must be paid by the covered person, under the health
benefit plan, subject to network deductible and network
out-of-pocket limit.
_____(f) All amounts paid as copayment, coinsurance and deductible
count toward the out-of-pocket limit, and may not be excluded
because of the nature of the service rendered, the illness or condition being treated, or for any other reason, except carriers
may, provided the terms of the health benefit plan so state, elect
to exclude from the out-of-pocket limit the cost sharing associated
with prescription drug coverage, whether provided as part of the
health benefit plan or as a rider.
§33-25A-31. Policies discriminating among health care providers.
Notwithstanding any other provisions of law, when any health
insurance policy, health care services plan or other contract
provides for the payment of medical expenses, benefits or
procedures, such the policy, plan or contract shall be construed to
include payment to all health care providers including, but not
limited to, medical physicians, osteopathic physicians, podiatric
physicians, chiropractic physicians, physical therapists,
occupational therapists, midwives, and nurse practitioners and
their licensed assistants, who provide medical services, benefits
or procedures which are within the scope of each respective
provider's license. Any limitation or condition placed upon
services, diagnoses or treatment by, or payment to any particular
type of licensed provider shall apply equally to all types of
licensed providers without unfair discrimination as to the usual
and customary treatment procedures of any of the aforesaid
providers.
ARTICLE 28. INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE MINIMUM
STANDARDS.
§33-28-8. Policies discriminating among health care providers.
_____Notwithstanding any other provisions of law, when any health
insurance policy, health care services plan or other contract
provides for the payment of medical expenses, benefits or
procedures, the policy, plan or contract shall be construed to
include payment to all health care providers including, but not
limited to, medical physicians, osteopathic physicians, podiatric
physicians, chiropractic physicians, physical therapists,
occupational therapists, midwives, nurse practitioners and their
licensed assistants, who provide medical services, benefits or
procedures which are within the scope of each respective provider's
license. Any limitation or condition placed upon services,
diagnoses or treatment by, or payment to any particular type of
licensed provider shall apply equally to all types of licensed
providers without unfair discrimination as to the usual and
customary treatment procedures of any of the aforesaid providers.
§33-28-9. Third party reimbursement for rehabilitation services.
_____(a) Notwithstanding any provision of any policy, provision,
contract, plan or agreement to which this article applies, any
entity regulated by this article shall, on or after July 1, 2013,
provide as benefits to all subscribers and members coverage for
rehabilitation services as hereinafter set forth, unless rejected
by the insured.
_____(b) Medically necessary rehabilitation services. -- Rehabilitation, as part of an individual's health care, is
considered medically necessary as determined by the qualified
health care provider based on the results of an evaluation and when
provided for the purpose of preventing, minimizing or eliminating
impairments, activity limitations or participation restrictions.
Rehabilitation services are delivered throughout the episode of
care by the qualified health care provider or under his or her
direction and supervision; requires the knowledge, clinical
judgment, and abilities of the qualified health care provider;
takes into consideration the potential benefits and harms to the
patient/client; and is not provided exclusively for the convenience
of the patient/client. Rehabilitation services are provided using
evidence of effectiveness and applicable standards of practice and
is considered medically necessary if the type, amount and duration
of services outlined in the plan of care increase the likelihood of
meeting one or more of these stated goals: to improve function,
minimize loss of function, or decrease risk of injury and disease.
_____(c) For purposes of this article and section, "rehabilitation
services" includes those services which are designed to remediate
patient's condition or restore patients to their optimal physical,
medical, psychological, social, emotional, vocational and economic
status. Rehabilitative services include by illustration and not
limitation diagnostic testing, assessment, monitoring or treatment
of the following conditions individually or in a combination:
_____(1) Stroke;
_____(2) Spinal cord injury;
_____(3) Congenital deformity;
_____(4) Amputation;
_____(5) Major multiple trauma;
_____(6) Fracture of femur;
_____(7) Brain injury;
_____(8) Polyarthritis, including rheumatoid arthritis;
_____(9) Neurological disorders, including, but not limited to,
multiple sclerosis, motor neuron diseases, polyneuropathy, muscular
dystrophy and Parkinson's disease;
_____(10) Cardiac disorders, including, but not limited to, acute
myocardial infarction, angina pectoris, coronary arterial
insufficiency, angioplasty, heart transplantation, chronic
arrhythmias, congestive heart failure, valvular heart disease;
_____(11) Burns;
_____(12) Orthopedic Disorders;
_____(13) Chronic Diseases including, but not limited to, diabetes,
hypertension and obesity;
_____(14) Fall prevention and treatment;
_____(d) Rehabilitative services includes care rendered by any of
the following:
_____(1) A hospital duly licensed by the State of West Virginia
that meets the requirements for rehabilitation hospitals as described in Section 2803.2 of the Medicare Provider Reimbursement
Manual, Part 1, as published by the U.S. Health Care Financing
Administration;
_____(2) A distinct part rehabilitation unit in a hospital duly
licensed by the State of West Virginia. The distinct part unit
must meet the requirements of Section 2803.61 of the Medicare
Provider Reimbursement Manual, Part 1, as published by the U.S.
Health Care Financing Administration;
_____(3) A hospital duly licensed by the State of West Virginia
which meets the requirements for cardiac rehabilitation as
described in Section 35-25, Transmittal 41, dated August, 1989, as
promulgated by the U.S. Health Care Financing Administration.
_____(4) Physical Therapists, Occupational Therapists and Speech
Language Pathologists; (qualified health care professionals
currently authorized under federal law (42 C.F.R. § 484.4)
_____(e) Rehabilitation services do not include services for mental
health, chemical dependency, vocational rehabilitation, long-term
maintenance or custodial services.
_____(f) A policy, provision, contract, plan or agreement shall
apply to rehabilitation services the same deductibles, coinsurance
and other limitations as apply to other covered services.
NOTE: The purpose of this bill is to create the West Virginia
Fair Health Insurance Act of 2013. The bill defines "illusionary benefit" to require benefits to cover at least seventy-five percent
of health care service. It establishes reasonable copays among
common insurance needs. It prevents insurance companies from
discriminating against licensed health care practitioners to whom
they will pay for a covered service. The bill prevents insurance
companies from arbitrarily defining medically necessary
rehabilitation services to avoid making payment for a covered
service or for a service that should be covered. The bill makes
physical therapy and rehabilitation services a mandated covered
service for any health insurance plan. And, the bill increases the
monetary criminal penalty for insurance companies that violate any
provisions of the chapter.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.
§33-1-22, §33-15-22, §33-16-18, §
33-16D-17, §
33-16D-18,
§
33-16D-19, §
33-24-7l, §
33-25-8i, §
33-25A-8k, §
33-28-8 and §
33-28-9
are new; therefore, they have been completely underscored.