ENGROSSED
Senate Bill No. 1011
(By Senator Tomblin (Mr. President))
(By Request of the Executive)
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[Introduced May 13, 2010; referred to the
Committee on the Judiciary; and then to
the Committee on Finance.]
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A BILL to amend the Code of West Virginia, 1931, as amended, by
adding thereto a new section, designated §33-2-23, relating to
effectuating the federal Patient Protection and Affordable
Care Act of 2010; authorizing the Insurance Commissioner to
apply for and expend certain federal grants; authorizing the
Insurance Commissioner to enter into contracts to implement
insurance programs authorized under the federal Patient
Protection and Affordable Care Act of 2010; exempting certain
contracts from the state purchasing rules; authorizing the
Insurance Commissioner to designate a plan administrator;
establishing a special revenue account in the State Treasury;
authorizing investment; and authorizing the Insurance
Commissioner to promulgate emergency and legislative rules to
effectuate certain provisions of the federal Patient
Protection and Affordable Care Act of 2010.
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 section, designated §33-2-23, to read as
follows:
ARTICLE 2. INSURANCE COMMISSIONER.
§33-2-23. Implementation of federal programs under the Patient
Protection and Affordable Care Act of 2010; authority
of commissioner; exemption from purchasing rules;
operation of a temporary high risk pool program;
special revenue account established; rulemaking.
(a) The Insurance Commissioner may apply for and expend
federal grants and may enter into contracts on behalf of the state
with the federal government or its agencies, other states,
political subdivisions of this state, corporations, associations,
partnerships or individuals to implement or participate in any
insurance program authorized under the Patient Protection and
Affordable Care Act of 2010, Pub. Law No. 111-148, §1101
:
Provided, That the provisions of article three, chapter five-a of
this code do not apply to any contracts executed by or on behalf of
the commissioner pursuant to this section.
(b) Upon the execution of a contract with the federal
government to implement a temporary high risk pool program under
the Patient Protection and Affordable Care Act of 2010, the
commissioner may:
(1) Designate the Public Employees Insurance Agency as plan administrator for such program:
Provided, That if such agency is
so designated, it may reimburse health care providers at the same
health care reimbursement rates then in effect for the West
Virginia Public Employees Insurance Agency and such health care
providers are prohibited from balance billing enrollees as set
forth in section four, article twenty-nine-d, chapter sixteen of
this code;
(2) Require the board of directors of the West Virginia Health
Insurance Plan to implement the program in accordance with a plan
of operation approved by the commissioner
: Provided, That if the
board is required to implement the program and fails to submit a
satisfactory plan of operation to the commissioner on or before
June 15, 2010, the commissioner may promulgate an emergency rule as
is necessary for the board to implement the federal high risk pool
program; or
(3) Contract with any insurer or third party administrator
licensed in this state to administer or exercise other duties
incident to the operation of such high risk pool program.
(c) All moneys collected from participants in the high risk
pool program established pursuant to this section shall be
deposited in a special account in the State Treasury to be known as
the "Qualified High Risk Premium Fund." The Qualified High Risk
Premium Fund shall be invested in the manner permitted by articles
six and six-c, chapter twelve of this code, with the interest
income a proper credit to the fund, unless otherwise designated by
law. The fund shall be administered by the commissioner and used to pay all proper costs incurred in implementing the provisions of
this section, all administrative costs of the program, all claims,
and proper ongoing costs of the program. Moneys deposited into
this account are available for expenditure as the commissioner may
direct in accordance with the provisions of this section. Nothing
in this section may be construed to mandate additional funding for
this program or to require any additional appropriation by the
Legislature. Funds paid into the account may also be derived from
any gifts, grants, bequests, transfers or donations which may be
received from any governmental entity or any person, firm,
foundation or corporation.
(d) The commissioner may, in accordance with the provisions of
article three, chapter twenty-nine-a of this code, propose
legislative rules and promulgate emergency rules to effectuate the
insurance provisions of the Patient Protection and Affordable Care
Act of 2010.