H. B. 2676

(By Delegate Gallagher)
[Introduced March 23, 1993; referred to the
Select Committee on Health Care Policies.]

A BILL to amend article six, chapter thirty-three of the code of West Virginia, one thousand nine hundred thirty-one, as amended, by adding thereto a new section, designated section twenty-two-a; to amend article fifteen of said chapter by adding thereto a new section, designated section seventeen; to amend article fifteen-a of said chapter by adding thereto a new section, designated section eight; to amend article sixteen of said chapter by adding thereto a new section, designated section twelve; to amend article sixteen-c of said chapter by adding thereto a new section, designated section eleven; to amend article sixteen-d of said chapter by adding thereto new section, designated section fourteen; to amend article twenty-four of said chapter by adding thereto a new section, designated section forty-five; to amend article twenty-five of said chapter by adding thereto new section, designated section twenty-two; to amend article twenty-five-a of said chapter by adding thereto new section,

designated section thirty-three, all relating to assignment of benefits to hospitals from policies, contracts and certificates issued under this chapter thirty-three; specifying types of assignments of benefits that insured may make; requiring insurers and other entities governed or regulated by the above cited articles within chapter thirty- three, to pay policy benefits to assignees; if, following receipt of assignments, payments were improperly made to insureds; prohibiting certain insurance policies from requiring benefits to be paid to particular persons or entities; prohibiting any reduction in the amount of benefits payable or scope of benefits allowed by any policy, contract or certificate to be modified due to the assignment; allowing for partial repeal of section twenty, section twenty-two of article six of said chapter thirty-three; severability clause.
Be it enacted by the Legislature of West Virginia:
That article six, chapter thirty-three of the code of West Virginia, one thousand nine hundred thirty-one, as amended, be amended by adding thereto a new section, designated section twenty-two-a; that article fifteen of said chapter be amended by adding a new section, designated section seventeen; that article fifteen-a of said chapter be amended by adding thereto a new section, designated section eight; that article sixteen of said chapter be amended by adding there to a new section, designated section twelve; that article sixteen-c of said chapter be amendedby adding thereto a new section, designated section eleven; that article sixteen-d of said chapter be amended by adding thereto a new section, designated section fourteen; that article twenty- four of said chapter be amended by adding thereto a new section, designated section forty-five; that article twenty-five of said chapter be amended by adding thereto a new section, designated section twenty-two; and that article twenty-five-a of said chapter be amended by adding thereto a new section, designated section thirty-three, all to read as follows:

ARTICLE 6. THE INSURANCE POLICY.

§33-6-22a. Assignment of benefits to licensed hospitals; no reduction in amount of moneys payable or scope of coverage by virtue of assignment; required payments to assignees; requiring benefits to be paid only to certain persons prohibited; partial repeal of sections twenty and twenty-two of this article; allowing for a private or public cause of action to enforce provisions of this section; remedies nonexclusive; severability.

(a) Any person insured by a policy, contract or certificate issued under any of the provisions of this chapter may assign in writing any benefits from the policy, contract or certificate to any person or persons, partnership, association or corporation who is a licensed hospital that has rendered a service or services under the policy, contract or certificate. Any entity governed by this chapter shall, upon written notice of anassignment, pay all or the part of the benefit assigned directly to the assignee.
(b) Any obligor, and any entity governed by this chapter, which receives written notice of the assignment and, disregarding the notice, pays the assigned benefits to the insured, in no way limits its obligation and liability to pay those benefits to the assignee, and shall do so irrespective of any and all payments made to the insured once an assignment has been created.
(c) Any policy, contract or certificate issued under any provision of this chapter may not require that the benefits provided hereunder be rendered to any particular person or persons, partnership, corporation or other entity: Provided, That this subsection does not apply to policies, contracts or certificates issued pursuant to article twenty-five-a of this chapter.
(d) Nothing in this section modifies the scope of coverage or amount of benefits payable under any policy, contract or certificate.
(e) To the extent that any provision within this section twenty-two-a conflicts with the provisions contained in sections twenty or twenty-two of article six of this chapter, sections twenty and twenty-two are hereby repealed.
(f) Any hospital which has rendered a service or services under any policy, contract or certificate under any of the provisions of this chapter and which holds an assignment, any assignor, the commissioner of insurance, the attorney general, orthe prosecuting attorney in the county in which health services were actually provided may institute any actions in law or equity in order to enjoin repeated violations of this section, recover damages from any entity governed by this chapter for its negligent or deliberate failure to comply with this section twenty-two-a, and, if appropriate, petition for damages to deter future violations. The remedies contained herein are not exclusive, nor does this subsection preempt or impair any other right to relief which exists under common law or equity, other sections of this article or chapter, or any other statute, ordinance or rule.
(g) The provisions of this section are severable; if any provision or part thereof is invalid, unconstitutional or inapplicable to any person or circumstance, such invalidity, unconstitutionality or inapplicability shall not affect or impair any other remaining provisions contained herein.

ARTICLE 15. ACCIDENT AND SICKNESS INSURANCE.

§33-15-17. Assignment of benefits to licensed hospitals; no reduction in amount of moneys payable or scope of coverage by virtue of assignment; required payments to assignees; requiring benefits to be paid only to certain persons prohibited; partial repeal of sections twenty and twenty-two of article six of this chapter; allowing for a private or public cause of action to enforce provisions of this section; remedies nonexclusive; severability.

(a) Any person insured by a policy, contract or certificate issued under any of the provisions of this article may assign in writing any benefits from the policy, contract or certificate to any person or persons, partnership, association or corporation who is a licensed hospital that has rendered a service or services under the policy, contract or certificate. Any entity governed by this article shall, upon written notice of an assignment, pay all or the part of the benefit assigned directly to the assignee.
(b) Any obligor, and any entity governed by this article, which receives written notice of the assignment and, disregarding the notice, pays the assigned benefits to the insured, in no way limits its obligation and liability to pay those benefits to the assignee, and shall do so irrespective of any and all payments made to the insured once an assignment has been created.
(c) Any policy, contract or certificate issued under any provision of this article may not require that the benefits provided hereunder be rendered to any particular person or persons, partnership, corporation or other entity: Provided, That this subsection does not apply to policies, contracts or certificates issued pursuant to article twenty-five-a of this chapter.
(d) Nothing in this section modifies the scope of coverage or amount of benefits payable under any policy, contract or certificate.
(e) To the extent that any provision within this sectionseventeen conflicts with the provisions contained in sections twenty or twenty-two of article six of this chapter, sections twenty and twenty-two contained within article six are hereby repealed.
(f) Any hospital which has rendered a service or services under any policy, contract or certificate under any of the provisions of this article and which holds an assignment, any assignor, the commissioner of insurance, the attorney general, or the prosecuting attorney in the county in which health services were actually provided may institute any actions in law and/or equity in order to enjoin repeated violations of this section, recover damages from any entity governed by this chapter for its negligent or deliberate failure to comply with this section seventeen, and, if appropriate, petition for damages to deter future violations of this same section. The remedies contained herein are not exclusive, nor does this subsection preempt or impair any other right to relief which exists under common law or equity, other sections of this article or any other statute, ordinance or rule.
(g) The provisions of this section are severable; if any provision or part thereof is invalid, unconstitutional or inapplicable to any person or circumstance, such invalidity, unconstitutionality or inapplicability shall not affect or impair any other remaining provisions contained herein.

ARTICLE 15A. LONG TERM CARE INSURANCE.

§33-15A-8. Assignment of benefits to licensed hospitals; no

reduction in amount of moneys payable or scope of coverage by virtue of assignment; required payments to assignees; requiring benefits to be paid only to certain persons prohibited; partial repeal of sections twenty and twenty-two of article six of this chapter; allowing for a private or public cause of action to enforce provisions of this section; remedies nonexclusive; severability.
(a) Any person insured by a policy, contract or certificate issued under any of the provisions of this chapter may assign in writing any benefits from the policy, contract or certificate to any person or persons, partnership, association or corporation who is a licensed hospital that has rendered a service or services under the policy, contract or certificate. Any entity governed by this article shall, upon written notice of an assignment, pay all or the part of the benefit assigned directly to the assignee.
(b) Any obligor, and any entity governed by this section, which receives written notice of the assignment and, disregarding the notice, for any reason pays the assigned benefits to the insured, in no way limits its obligation and liability to pay those benefits to the assignee, and shall do so irrespective of any and all payments made to the insured: Provided, That the notice of assignment has been received.
(c) Any policy, contract or certificate issued under any provision of this chapter may not require that the benefitsprovided hereunder be rendered to any particular person or persons, partnership, corporation or other entity: Provided, That this subsection does not apply to policies, contracts or certificates issued pursuant to article twenty-five-a of this chapter.
(d) Nothing in this section modifies the scope of coverage or amount of benefits payable under any policy, contract or certificate.
(e) To the extent that any provision within this section eight conflicts with the provisions contained in sections twenty or twenty-two of article six of this chapter, the sections contained within article six are hereby repealed.
(f) Any hospital which has rendered a service or services under any policy, contract or certificate under any of the provisions of this chapter and which holds an assignment, any assignor, the commissioner of insurance, the attorney general, or the prosecuting attorney in the county in which health services were actually provided may institute any actions in law and/or equity in order to enjoin repeated violations of this section, recover damages from any entity governed by this chapter for its negligent or deliberate failure to comply with this section eight, and, if appropriate, petition for damages to deter future violations of this same section. The remedies contained herein are not exclusive, nor does this subsection preempt or impair any other right to relief which exists under common law or equity, other sections of this article or any other statute, ordinance orrule.
(g) The provisions of this section are severable; if any provision or part thereof is invalid, unconstitutional or inapplicable to any person or circumstance, such invalidity, unconstitutionality or inapplicability shall not affect or impair any other remaining provisions contained herein.

ARTICLE 16. GROUP ACCIDENT AND SICKNESS INSURANCE.

§33-16-12. Assignment of benefits to licensed hospitals; no reduction in amount of moneys payable or scope of coverage by virtue of assignment; required payments to assignees; requiring benefits to be paid only to certain persons prohibited; partial repeal of sections twenty and twenty-two of article six of this chapter; allowing for a private or public cause of action to enforce provisions of this section; remedies nonexclusive; severability.

(a) Any person insured by a policy, contract or certificate issued under any of the provisions of this chapter may assign in writing any benefits from that policy, contract or certificate to any person or persons, partnership, association or corporation who is a licensed hospital that has rendered a service or services under the policy, contract or certificate. Any entity governed by this article shall, upon written notice of an assignment, pay all or the part of the benefit assigned directly to the assignee.
(b) Any obligor, and any entity governed by this section,which receives written notice of the assignment and, disregarding this notice, for any reason pays the assigned benefits to the insured, in no way limits its obligation and liability to pay those benefits to the assignee, and shall do so irrespective of any and all payments made to the insured: Provided, That the notice of assignment has been received.
(c) Any policy, contract or certificate issued under any provision of this chapter does not require that the benefits provided hereunder be rendered to any particular person or persons, partnership, corporation or other entity: Provided, That this subsection may not apply to policies, contracts or certificates issued pursuant to article twenty-five-a of this chapter.
(d) Nothing in this section modifies the scope of coverage or amount of benefits payable under any policy, contract or certificate.
(e) To the extent that any provision within this section twelve conflicts with the provisions contained in sections twenty or twenty-two of article six of this chapter, the sections contained within article six are hereby repealed.
(f) Any hospital which has rendered a service or services under any policy, contract or certificate under any of the provisions of this chapter and which holds an assignment, any assignor, the commissioner of insurance, the attorney general, or the prosecuting attorney in the county in which health services were actually provided may institute any actions in law and/orequity in order to enjoin repeated violations of this section, recover damages from any entity governed by this chapter for its negligent or deliberate failure to comply with this section twelve, and, if appropriate, petition for damages to deter future violations of this same section. The remedies contained herein are not exclusive, nor does this subsection preempt or impair any other right to relief which exists under common law or equity, other sections of this article or any other statute, ordinance or rule.
(g) The provisions of this section are severable; if any provision or part thereto is invalid, unconstitutional or inapplicable to any person or circumstance, such invalidity, unconstitutionality or inapplicability shall not affect or impair any other remaining provisions contained herein.

ARTICLE 16C. EMPLOYER GROUP ACCIDENT AND SICKNESS INSURANCE POLICIES.

§33-16C-11. Assignment of benefits to licensed hospitals; no reduction in amount of moneys payable or scope of coverage by virtue of assignment; required payments to assignees; requiring benefits to be paid only to certain persons prohibited; partial repeal of sections twenty and twenty-two of article six of this chapter; allowing for a private or public cause of action to enforce provisions of this section; remedies nonexclusive; severability.

(a) Any person insured by a policy, contract or certificateissued under any of the provisions of this article may assign in writing any benefits from this policy, contract or certificate to any person or persons, partnership, association or corporation who is a licensed hospital that has rendered a service or services under the policy, contract or certificate. Any entity governed by this article shall, upon written notice of an assignment, pay all or the part of the benefit assigned directly to the assignee.
(b) Any obligor, and any entity governed by this section, which receives written notice of the assignment and, disregarding the notice, for any reason pays the assigned benefits to the insured, in no way limits its obligation and liability to pay those benefits to the assignee, and shall do so irrespective of any and all payments made to the insured: Provided, That the notice of assignment has been received.
(c) Any policy, contract or certificate issued under any provision of this chapter may not require that the benefits provided hereunder be rendered to any particular person or persons, partnership, corporation or other entity: Provided, That this subsection does not apply to policies, contracts or certificates issued pursuant to article twenty-five-a of this chapter.
(d) Nothing in this section modifies the scope of coverage or amount of benefits payable under any policy, contract or certificate.
(e) To the extent that any provision within this sectioneleven conflicts with the provisions contained in sections twenty or twenty-two of article six of this chapter, such sections contained within article six are hereby repealed.
(f) Any hospital which has rendered a service or services under any policy, contract or certificate under any of the provisions of this chapter and which holds an assignment, any assignor, the commissioner of insurance, the attorney general, or the prosecuting attorney in the county in which health services were actually provided may institute any actions in law and/or equity in order to enjoin repeated violations of this section, recover damages from any entity governed by this chapter for its negligent or deliberate failure to comply with this section eleven, and, if appropriate, petition for damages to deter future violations of this same section. The remedies contained herein are not exclusive, nor does this subsection preempt or impair any other right to relief which exists under common law or equity, other sections of this article or any other statute, ordinance or rule.
(g) The provisions of this section are severable; if any provision or part thereof is invalid, unconstitutional or inapplicable to any person or circumstance, the invalidity, unconstitutionality or inapplicability shall not affect or impair any other remaining provisions contained herein.

ARTICLE 16D. MARKETING AND RATE PRACTICES FOR SMALL EMPLOYER ACCIDENT AND SICKNESS INSURANCE POLICIES.

§33-16D-14. Assignment of benefits to licensed hospitals; no

reduction in amount of moneys payable or scope of coverage by virtue of assignment; required payments to assignees; requiring benefits to be paid only to certain persons prohibited; partial repeal of sections twenty and twenty-two of article six of this chapter; allowing for a private or public cause of action to enforce provisions of this section; remedies nonexclusive; severability.
(a) Any person insured by a policy, contract or certificate issued under any of the provisions of this chapter may assign in writing any benefits from the policy, contract or certificate to any person or persons, partnership, association or corporation who is a licensed hospital that has rendered a service or services under the policy, contract or certificate. Any entity governed by this article shall, upon written notice of an assignment, pay or the part of the benefit assigned directly to the assignee.
(b) Any obligor, and any entity governed by this section, which receives written notice of the assignment and, disregarding the notice, for any reason pays the assigned benefits to the insured, in no way limits its obligation and liability to pay those benefits to the assignee, and shall do so irrespective of any and all payments made to the insured: Provided, That the notice of assignment has been received.
(c) Any policy, contract or certificate issued under any provision of this chapter may not require that the benefitsprovided hereunder be rendered to any particular person or persons, partnership, corporation or other entity: Provided, That this subsection does not apply to policies, contracts or certificates issued pursuant to article twenty-five-a of this chapter.
(d) Nothing in this section modifies the scope of coverage or amount of benefits payable under any policy, contract or certificate.
(e) To the extent that any provision within this section conflicts with the provisions contained in section twenty or twenty-two of article six of this chapter, the sections contained within article six are hereby repealed.
(f) Any hospital which has rendered a service or services under any policy, contract or certificate under any of the provisions of this chapter and which holds an assignment, any assignor, the commissioner of insurance, the attorney general, or the prosecuting attorney in the county in which health services were actually provided may institute any actions in law and/or equity in order to enjoin repeated violations of this section, recover damages from any entity governed by this chapter for its negligent or deliberate failure to comply with this section fourteen, and, if appropriate, petition for damages to deter future violations of this same section. The remedies contained herein are not exclusive, nor does this subsection preempt or impair any other right to relief which exists under common law or equity, other sections of this article or any other statute,ordinance or rule.
(g) The provisions of this section are severable; if any provision or part thereof is invalid, unconstitutional or inapplicable to any person or circumstance, the invalidity, unconstitutionality or inapplicability shall not affect or impair any other remaining provisions contained herein.

ARTICLE 24. HOSPITAL SERVICE CORPORATIONS, MEDICAL SERVICE CORPORATIONS, DENTAL SERVICE CORPORATIONS AND HEALTH SERVICE CORPORATIONS.

§33-24-45. Assignment or benefits to licensed hospitals; no reduction in amount of moneys payable or scope of coverage by virtue of assignment; required payments to assignees; requiring benefits to be paid only to certain persons prohibited; partial repeal of sections twenty and twenty-two of article six of this chapter; allowing for a private or public cause of action to enforce provisions of this section; remedies nonexclusive; severability.

(a) Any person insured by a policy, contract or certificate issued under any of the provisions of this chapter may assign in writing any benefits from the policy, contract or certificate to any person or persons, partnership, association or corporation who is a licensed hospital that has rendered a service or services under the policy, contract or certificate. Any entity governed by this article shall, upon written notice of an assignment, pay all or the part of the benefit assigned directlyto the assignee.
(b) Any obligor, and any entity governed by this section, which receives written notice of the assignment and, disregarding the notice, for any reason pays the assigned benefits to the insured, in no way limits its obligation and liability to pay those benefits to the assignee, and may do so irrespective of any and all payments made to the insured: Provided, That the notice of assignment has been received.
(c) Any policy, contract or certificate issued under any provision of this chapter does not require that the benefits provided hereunder be rendered to any particular person or persons, partnership, corporation or other entity: Provided, That this subsection does not apply to policies, contracts or certificates issued pursuant to article twenty-a of this chapter.
(d) Nothing in this section modifies the scope of coverage or amount of benefits payable under any policy, contract or certificate.
(e) To the extent that any provision within this section conflicts with the provisions contained in sections twenty or twenty-two of article six of this chapter, the sections twenty and twenty-two are hereby repealed.
(f) Any hospital which has rendered a service or services under any policy, contract or certificate under any of the provisions of this chapter and which holds an assignment, any assignor, the commissioner of insurance, the attorney general, or the prosecuting attorney in the county in which health serviceswere actually provided may institute any actions in law and/or equity in order to enjoin repeated violations of this section, recover damages from any entity governed by this chapter for its negligent or deliberate failure to comply with this section forty-five, and, if appropriate, petition for damages to deter future violations of this same section. The remedies contained herein are not exclusive, nor does this subsection preempt or impair any other right to relief which exists under common law or equity, other sections of this article or any other statute, ordinance or rule.
(g) The provisions of this section are severable; if any provision or part thereof is invalid, unconstitutional or inapplicable to any person or circumstance, such invalidity, unconstitutionality or inapplicability shall not affect or impair any other remaining provisions contained herein.

ARTICLE 25. HEALTH CARE CORPORATIONS.

§33-25-22. Assignment of benefits to licensed hospitals; no reduction in amount of moneys payable or scope of coverage by virtue of assignment; required payments to assignees; requiring benefits to be paid only to certain persons prohibited; partial repeal of sections twenty and twenty-two of article six of this chapter; allowing for a private or public cause of action to enforce provisions of this section; remedies nonexclusive; severability.

(a) Any person insured by a policy, contract or certificateissued under any of the provisions of this chapter may assign in writing any benefits from this policy, contract or certificate to any person or persons, partnership, association or corporation who is a licensed hospital that has rendered a service or services under the policy, contract or certificate. Any entity governed by this article shall, upon written notice of an assignment, pay all or the part of the benefit assigned directly to the assignee.
(b) Any obligor, and any entity governed by this section, which receives written notice of the assignment and, disregarding this notice, for any reason pays the assigned benefits to the insured, in no way limits its obligation and liability to pay those benefits to the assignee, and shall do so irrespective of any and all payments made to the insured: Provided, That the notice of assignment has been received.
(c) Any policy, contract or certificate issued under any provision of this chapter may not require that the benefits provided hereunder be rendered to any particular person or persons, partnership, corporation or other entity: Provided, That this subsection does not apply to policies, contracts or certificates issued pursuant to article twenty-five-a of this chapter.
(d) Nothing in this section modifies the scope of coverage or amount of benefits payable under any policy, contract or certificate.
(e) To the extent that any provision within this sectionconflicts with the provisions contained in sections twenty or twenty-two of article six of this chapter, sections twenty and twenty-two are hereby repealed.
(f) Any hospital which has rendered a service or services under any policy, contract or certificate under any of the provisions of this chapter and which holds an assignment, any assignor, the commissioner of insurance, the attorney general, or the prosecuting attorney in the county in which health services were actually provided may institute any actions in law and/or equity in order to enjoin repeated violations of this section, recover damages from any entity governed by this chapter for its negligent or deliberate failure to comply with this section twenty-two, and, if appropriate, petition for damages to deter future violations of this same section. The remedies contained herein are not exclusive, nor does this subsection preempt or impair any other right to relief which exists under common law or equity, other sections of this article or any other statute, ordinance or rule.
(g) The provisions of this section are severable; if any provision or part thereof is invalid, unconstitutional or inapplicability to any person or circumstance, the invalidity, unconstitutionality or inapplicability shall not affect or impair any other remaining provisions contained herein.

ARTICLE 25A. HEALTH MAINTENANCE ORGANIZATION.

§33-25A-33. Assignment of benefits to licensed hospitals; no reduction in amount of moneys payable or scope of

coverage by virtue of assignment; required payments to assignees; requiring benefits to be paid only to certain persons prohibited; partial repeal of sections twenty and twenty-two of article six of this chapter; allowing for a private or public cause of action to enforce provisions of this section; remedies nonexclusive; severability.
(a) Any person insured by a policy, contract or certificate issued under any of the provisions of this chapter may assign in writing any benefits from this policy, contract or certificate to any person or persons, partnership, association or corporation who is a licensed hospital that has rendered a service or services under the policy, contract or certificate. Any entity governed by this article shall, upon written notice of an assignment, pay all or the part of the benefit assigned directly to the assignee.
(b) Any obligor, and any entity governed by this section, which receives written notice of the assignment and, disregarding the notice, for any reason pays the assigned benefits to the insured, in no way limits its obligation and liability to pay those benefits to the assignee, and shall do so irrespective of any and all payments made to the insured: Provided, That the notice of assignment has been received.
(c) Any policy, contract or certificate issued under any provision of this chapter may not require that the benefits provided hereunder be rendered to any particular person orpersons, partnership, corporation or other entity: Provided, That this subsection does not apply to policies, contracts or certificates issued pursuant to article twenty-five-a of this chapter.
(d) Nothing in this section modifies the scope of coverage or amount of benefits payable under any policy, contract or certificate.
(e) To the extent that any provision within this section conflicts with the provisions contained in sections twenty or twenty-two of article six of this chapter, sections twenty and twenty-two are hereby repealed.
(f) Any hospital which has rendered a service or services under any policy, contract or certificate under any of the provisions of this chapter and which holds an assignment, any assignor, the commissioner of insurance, the attorney general, or the prosecuting attorney in the county in which health services were actually provided may institute any actions in law and/or equity in order to enjoin repeated violations of this section, recover damages from any entity governed by this chapter for its negligent or deliberate failure to comply with this section thirty-three, and, if appropriate, petition for damages to deter future violations of this same section. The remedies contained herein are not exclusive, nor does this subsection preempt or impair any other right to relief which exists under common law or equity, other sections of this article or any other statute, ordinance or rule.
(g) The provisions of this section are severable; if any provision or part thereof is invalid, unconstitutional or inapplicable to any person or circumstance, the invalidity, unconstitutionality or inapplicability shall not affect or impair any other remaining provisions contained herein.

NOTE: The purpose of this bill is to allow patients in hospitals to assign their insurance benefits to the hospital in order to pay their hospital bill.

These sections are new; therefore, strike-throughs and underscoring have been omitted.