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Introduced Version Senate Bill 685 History

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Senate Bill No. 685

(By Senators Minard, Unger, Kessler and Love)

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[Introduced March 21, 2005; referred to the Committee

on Banking and Insurance.]

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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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