H. B. 3146
(By Delegates Fragale, Eldridge, Perdue,
R. Thompson, Hatfield, Webster, Moore, G. White,
Marshall, Brown and Long)
[Introduced March 22, 2005; referred to the
Committee on Banking and Insurance then the Judiciary.]
A BILL to amend the Code of West Virginia, 1931, as amended, by
adding thereto a new article, designated §33-20G-1, §33-20G-2,
§33-20G-3 and §33-20G-4, all relating to prohibiting medical
professional liability insurers doing business in West
Virginia from issuing or enforcing underwriting guidelines
which purport to place restrictions or limitations upon
insureds in this state greater than any restrictions or
limitations set forth in this code or related administrative
rules.
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 §33-20G-1, §33-20G-2,
§33-20G-3 and §33-20G-4, all to read as follows:
ARTICLE 20G. UNDERWRITING GUIDELINES FOR MEDICAL PROFESSIONAL
LIABILITY INSURERS.
§33-20G-1. Legislative findings.
The Legislature declares that the citizens of West Virginia,
by and through the Legislature, set the standards and requirements
for the practice of medicine and related health care occupations,
including physicians, nurses and other similar fields. The
standards and requirements include the tasks and procedures that
nurses and similar health care professionals are permitted to
conduct or perform, and the circumstances under which these tasks
and procedures may be conducted or performed. The specific
standards and requirements are set forth in this code and within
related administrative rules promulgated with the approval of the
Legislature. Therefore, the Legislature finds that in order to
promote patients' access to quality care and to permit the
continued existence of valuable patient-provider relationships, no
agency or entity should be permitted to impose restrictions or
limitations upon health care providers, including physicians,
nurses and related occupations, which are greater than those set
forth in this code or related administrative rule.
§33-20G-2. Definitions.
In this article, unless the context otherwise requires:
(1) "Medical professional liability" means any liability for
damages resulting from the death or injury of a person for any tort
or breach of contract based on health care services rendered, or
which should have been rendered, by a health care provider or
health care facility to a patient.
(2) "Insured" means a person or entity who is provided medical
professional liability insurance coverage.
(3) "Underwriting guidelines" means, but is not limited to,
the acceptance of employer or individual applications for coverage
of individuals, in accordance with the written rules of the insurer
or self-funded plan; and the overall planning and coordinating of
a benefits program.
§33-20G-3
.
Prohibition on excessive restrictions or limitations
for medical professional liability insurers.
(a) Beginning on the first day of July, 2005, no medical
professional liability insurer doing business in West Virginia may
issue or enforce underwriting guidelines which purport to place
restrictions or limitations upon insureds in this state greater
than any restrictions or limitations upon permitted tasks or
procedures set forth in this code or related administrative rules.
(b) Violations of this section are to be remedied as set forth
in section four of this article.
§33-20G-4. Enforcement.
In addition to any remedies available at common law, the
Insurance Commissioner shall receive and review written complaints
regarding compliance with this article. The Insurance Commissioner
may use all investigatory tools available to verify compliance with
this article. If the Insurance Commissioner determines that a
medical professional liability insurer is not in compliance with any section of this article, the Commissioner shall:
(1) Impose a fine of ten thousand dollars for each violation
of this article. An additional fine of ten thousand dollars shall
be imposed for every thirty days a medical professional liability
insurer is not in compliance with this article; or
(2) Suspend or revoke the insurer's license or right to do
business in West Virginia.
NOTE: The purpose of this bill is to prohibit medical
professional liability insurers doing business in West Virginia
from issuing or enforcing underwriting guidelines which purport to
place restrictions or limitations upon insureds in this state
greater than any restrictions or limitations set forth in this code
or related administrative rules.
This article is new; therefore, strike-throughs and
underscoring have been omitted.
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