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Introduced Version House Bill 2618 History

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hb2618 intr
H. B. 2618


(By Delegates Brown, Hrutkay, Martin and Staton)
[Introduced February 23, 2005
; referred to the
Committee on Banking and Insurance then Finance.
]




A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto a new article, designated §33-16E-1, §33-16E-2, §33-16E-3, §33-16E-4 and §33-16E-5, all relating to requiring health insurance plans to cover the cost of contraceptives for its covered people.

Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended by adding thereto a new article, designated §33-16E-1, §33-16E-2, §33-16E-3, §33-16E-4 and §33-16E-5, all to read as follows:
ARTICLE 16E. CONTRACEPTIVE COVERAGE.
§33-16E-1. Definitions.
For the purposes of this article, the words and phrases defined in this section have the meanings ascribed to them. These definitions are applicable unless a different meaning clearly appears from the context.
(1) "Covered person" means the policy holder, subscriber, certificate holder, enrollee, or other individual who is participating in, or receiving coverage under, a health insurance plan.
(2) "Health insurance plan" means any individual or group plan, policy, certificate, subscriber contract, or contract of insurance provided by a managed care plan, preferred provider agreement, or health maintenance organization that is delivered, issued, renewed, modified, amended or extended by a health insurer in this state that pays for or purchases health care services for covered persons.
(3)"Health insurer" means a disability insurer, health care insurer, health maintenance organization, accident and sickness insurer, fraternal benefit society, nonprofit hospital service corporation, health service corporation, health care service plan, preferred provider organization or arrangement, or multiple employer welfare arrangement.
(4) "Outpatient contraceptive services" means consultations, examinations, procedures and medical services, provided on an outpatient basis and related to the use of contraceptive drugs and devices to prevent pregnancy.
§33-16E-2. Parity for contraceptive drugs, devices and outpatient services.

(1) Health insurance plans that provide benefits for prescription drugs or devices may not exclude or restrict benefits to covered persons for any prescription contraceptive drug or device approved by the Federal Food and Drug Administration.
(2) Health insurance plans that provide benefits for outpatient services provided by a health care professional may not exclude or restrict outpatient contraceptive services for covered persons.
§33-16E-3. Extraordinary surcharges prohibited.
A health insurance plan is prohibited from:
(1) Imposing deductibles, copayments, other cost-sharing mechanisms, or waiting periods or prescription contraceptive drugs or devices greater than deductibles, copayments, other cost-sharing mechanisms, or waiting periods for other covered prescription drugs or devices.
(2) Imposing deductibles, copayments, other cost-sharing mechanisms, or waiting periods for outpatient contraceptive services greater than such deductibles, copayments, other cost-sharing mechanisms, or waiting periods for other covered outpatient services.
§33-16E-4. Additional prohibitions.
A health insurance plan is prohibited from:
(1) Denying eligibility, enrollment, or renewal of coverage to any individual because of their use or potential use of contraceptives.
(2) Providing monetary payments or rebates to covered persons to encourage them to accept less than the minimum protections available under this section.
(3) Penalizing, or otherwise reducing or limiting the reimbursement of a health care professional because such professional prescribed contraceptive drugs or devices, or provided contraceptive services.
(4) Providing incentives, monetary or otherwise, to a health care professional to induce such professional to withhold contraceptive drugs, devices or services from covered persons.
§33-16E-5. Enforcement.
In addition to any remedies at common law, the insurance commissioner shall receive and review written complaints regarding compliance with this section. The insurance commissioner may use all investigatory tools available to verify compliance with this section. If the insurance commissioner determines that a health insurance plan is not in compliance with any section in this article, the commissioner shall:
(1) Impose a fine of $10,000 per violation of this section. An additional $10,000 shall be imposed for every thirty days that a health insurance plan is not in compliance; and/or
(2) Suspend or revoke the certificate of authority or deny the health insurer's application for a certificate of authority.


NOTE: The purpose of this bill is to require insurers to cover the cost of contraceptives acquired by covered persons, just as it would for any other medication.

This article is new; therefore, strike-throughs and underscoring have been omitted.
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