H. B. 3113


(By Delegates Perdue, Fleischauer,
Hatfield, Brown, Amores, Manchin, Palumbo,


Canterbury, Hutchins, Browning and Boggs)

[Introduced February 16, 2007; referred to the
Committee on Finance.]


A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto a new article, designated §5-1F-1, §5-1F-2, §5-1F-3, §5-1F-4 and §5-1F-5, all relating to the Medical Cost Containment Act; creating the Governor's Health Care Partnership Council; prescribing duties for the Council; providing for the review of new technologies; and providing for advanced directives of living wills, medical powers of attorney and combined medical powers of attorney and living wills.

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 §5-1F-1, §5-1F-2, §5-1F-3, §5-1F-4 and §5-1F-5, all to read as follows:
ARTICLE 1F. MEDICAL COST CONTAINMENT ACT.
§5-1F-1. The Governor's Health Care Partnership Council Created.
There is hereby created the Governor's Health Care Partnership Council. The Governor, or his or her designee, shall chair the Council. The Council shall also be comprised of the Director of the Public Employees Insurance Agency, the Director of Medical Services within the Department of Health and Human Resources, the Director of the Children's Health Insurance Program, the Chief Executive Officers or their designee of Mountain State Blue Cross Blue Shield, the Health Plan of the Upper Ohio Valley, and Carelink. Other insurance carriers licensed to do business in West Virginia may petition the Council for membership to the Council, which upon the majority vote of the members of the Council additional insurance carriers will be granted full membership in the Council.
§5-1F-2. Duties of the Council.
The Council shall determine ways to reduce costs in the provision of health care in the state. The Council may employ all such consultants, actuaries and other experts as it deems necessary. The Council shall complete its report and submit recommendations to the Legislative Oversight Commission on Health and Human Resources Accountability by no later than the first day of December, two thousand seven and by the first day of December of each year thereafter. Such report shall include among other things its recommendations as to the statutory and administrative changes necessary to ensure that quality health care will be delivered to the citizens of the state as economically and efficiently as practicable.
The Council's duties shall include, but shall not be limited to, exploring the funding of new and proven more efficient and cost-saving procedures available to provide health care, such as electronic prescriptions, the maintenance of medical records using secure electronic media, a common disease management or care management system, the use of a statewide nurse "hotline" to enable all residents of the state to obtain medical advice by telephone, common claims forms and procedures for health care providers to submit claims to public and private insurers and other joint programs that will improve the delivery of health care in West Virginia.
§5-1F-3. Health Care Budget Process.
The Health Care Authority (hereafter authority) shall establish by the first day of December, two thousand seven and by the first day of December of each year, thereafter a projected annual budget for the ensuing calendar year, which shall include the total amount to be spent for health care in the state, and as separate items, the amount to be spent in each sector of health care, e.g., inpatient and outpatient treatment, pharmaceuticals, professional services, durable medical equipment, and other categories as established by the authority and the Council. By no later than the fifteenth day of January, two thousand eight and by the fifteenth day of January of each year thereafter, the authority shall compile the total amount actually spent in West Virginia in the preceding calendar year and shall compare these amounts with the respective budgeted amounts for such calendar year. In compiling either the projected annual expenditures or the actual annual expenditures the authority may request the aggregate claims projection or the aggregate claims experience of the public and private payers of health care that are members of the Council. The public payers on the Council shall provide the authority any aggregate data requested by the authority. The private payers on the Council may, in their own discretion, provide the authority with aggregate data requested by the authority. If the total budget or any category of the budget exceeds the budgeted amount, the authority shall make recommendations to the Governor and the Legislature on ways in which these items may be better controlled in the future.
§5-1F-4. Technology.
The authority shall collaborate with the state of Oregon and/or other states it may designate in establishing a process for the independent review of the cost effectiveness of such new technology and procedures. The review of new technologies or procedures shall include determining the populations most likely to benefit from the new technologies or procedures and may recommend that the new technologies and procedures are inappropriate for certain populations. The authority shall report to the Legislative Oversight Commission on Health and Human Resources Accountability by no later than the first day of December, two thousand seven and the first day of December of each year thereafter as to its findings and recommendations.
§5-1F-5. Advanced directives.
Prior to the first day of May, two thousand seven and every year thereafter, the Public Employees Insurance Agency shall distribute to all employees and retirees covered by the Public Employees Insurance Agency a copy of advance directives of living wills and medical powers of attorney and combined medical powers of attorney and living wills as provided in section four, article thirty, chapter sixteen of this code. The Public Employees Insurance Agency may use the combined form provided in section four, article thirty, chapter sixteen of this code. The PEIA Finance Board may reduce copayments, coinsurance or monthly premiums for employees or retirees who complete an advance directive.

NOTE: The purpose of this bill is to provide for the Medical Cost Containment Act. Toward this end, the bill creates the Governor's Health Care Partnership Council, prescribes duties for the Council and provides for the review of new medical technologies. The bill also provides for advanced directives of living wills, medical powers of attorney and combined medical powers of attorney and living wills.

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