SB 69 Text

Introduced Version Senate Bill 69 History

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sb69 intr Senate Bill No. 69
(By Senator Hunter)
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[Introduced February 9, 2005; referred to the Committee
on Banking and Insurance; and then to the Committee on Finance.]
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A BILL to amend and reenact §5-16B-1 of the Code of West Virginia, 1931, as amended, relating to expansion of health coverage to children; and providing exceptions to application and waiting period if existing coverage is excessively expensive for families with private health insurance.

Be it enacted by the Legislature of West Virginia:
That §5-16B-1 of the Code of West Virginia, 1931, as amended, be amended and reenacted to read as follows:
ARTICLE 16B. WEST VIRGINIA CHILDREN'S HEALTH PROGRAM.

§5-16B-1. Expansion of health care coverage to children; creation of program; legislative directives.

(a) It is the intent of the Legislature to expand access to health services for eligible children and to pay for this coverage by using private, state and federal funds to purchase those services or purchase insurance coverage for those services. To achieve this intention, the West Virginia children's health insurance program is hereby created. The program shall be administered by the children's health insurance agency within the department of administration in accordance with the provisions of this article and the applicable provisions of Title XXI of the Social Security Act of 1997. Participation in the program may be made available to families of eligible children, subject to eligibility criteria and processes to be established, which ~~shall~~ does not create an entitlement to coverage in any person: Provided, That the criteria must include that if it is determined that families with private health insurance cannot afford the cost of full family health coverage and are income eligible under this article, then they may make application for benefits under the West Virginia children's health insurance program without any additional waiting period. Nothing in this article may be construed to require any appropriation of state general revenue funds for the payment of any benefit provided for in this article. ~~In the event that~~ If this article conflicts with the requirements of federal law, federal law governs.
(b) In developing a children's health insurance program that operates with the highest degree of simplicity and governmental efficiency, the board shall avoid duplicating functions available in existing agencies and may enter into interagency agreements for the performance of specific tasks or duties at a specific or maximum contract price.
(c) In developing benefit plans, the board may consider any cost savings, administrative efficiency or other benefit to be gained by considering existing contracts for services with state health plans and negotiating modifications of those contracts to meet the needs of the program.
(d) Upon the transfer of the functions of the children's health insurance program from the department of health and human resources to the children's health insurance agency within the department of administration, the secretary of the department of health and human resources and the secretary of the department of administration, acting jointly, are empowered to authorize and shall authorize such transfers of program funds including, but not limited to, the West Virginia children's health fund created in section seven of this article and associated investment accounts; and transfers of children's health insurance program personnel and equipment, as are necessary, to facilitate an orderly transfer of the functions of the children's health insurance program. Authority to make transfers pursuant to this subsection expires on the thirty-first day of December, two thousand.
(e) In order to enroll as many eligible children as possible in the program created by this article and to expedite the effective date of their health insurance coverage, the board shall develop and implement a plan whereby applications for enrollment may be taken at any primary care center or other health care provider, as determined by the director, and transmitted electronically to the program's offices for eligibility screening and other necessary processing. The board may use any funds available to it in the development and implementation of the plan, including grant funds or other private or public moneys.

NOTE: The purpose of this bill is to provide exceptions to application and waiting period for the Children's Health Insurance when existing family coverage is determined to be excessively expensive for families with private health insurance.

Strike-throughs indicate language that would be stricken from the present law, and underscoring indicates new language that would be added.