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Committee Substitute House Bill 2747 History

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HB2747 SUB
COMMITTEE SUBSTITUTE


FOR

H. B. 2747


(By Delegates Perdue, Hatfield, Marshall, Michael,

Moore, Rodighiero, and Border)

[Originating in the Government Organization]

(March 24, 2009)


A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto a new section, designated §33-3-14e, all relating to creating a temporary health information technology reinvestment fee for health insurers; providing definitions; establishing penalties for noncompliance; providing rule- making authority; providing for reduction or elimination of fees if available funds exceed necessary amounts; and establishing an effective date.

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 §33-3-14e, to read as follows:
CHAPTER 33. INSURANCE.

ARTICLE 3. LICENSING, FEES AND TAXATION.
§33-3-14e. Health Care Information Technology Reinvestment Fee
.
(a) The Legislature finds the following:
(1) Improving the capability to access and exchange electronic health information is a key component of the health care reform efforts in West Virginia.
(2) The access and exchange of electronic health information improves the quality of care and the efficiency of health practitioners.
(3) The financing model of the existing health care system results in most of the financial benefits of the use of health information technology not being realized by the primary care practitioners who have to invest in and use the electronic medical record but by those who pay for health care services.
(4) Significant funding is potentially available under the federal American Recovery and Reinvestment Act (Public Law 111-16) to advance the purposes of this article if a state prepares to implement health information technology in alignment with that Act and provides necessary matching funds.
(b) As used in this section:
(1) "Commission" means the Insurance Commission.
(2) "Commissioner" means the commissioner of the Insurance Commission.
(3) "Health insurance" means any group or individual health care benefit policy, contract, or other health benefit plan offered, issued, renewed, or administered by any health insurer, including any health care benefit plan offered, issued, or renewed by any health insurance company, any nonprofit hospital and medical service corporation, or any managed care organization as defined in chapter 33 of this code. The term does include the Public Employees Insurance Agency. The term does not include Medicaid, State Children's Health Insurance Program, or any other state health care assistance program financed, in whole or in part, through a federal program, until authorized by the federal program. The term does not include policies issued for specified disease, accident, injury, hospital indemnity, dental care, long term care, disability income, or other limited benefit health insurance policies.
(4)"Health insurer" means an entity licensed by the commissioner to transact accident and sickness insurance in this state, service corporations licensed pursuant to article twenty-four of this chapter, health maintenance organizations licensed pursuant to article twenty-five-a of this chapter.
(5) "Health TPA" means a third part administrator registered in accordance with the provisions of section four, article forty-six, chapter sixteen, that handles health claims for any entity other than a health insurer.
(5) "WVHIN" is the West Virginia Health Information Network created in article twenty-nine-g, chapter sixteen.
(c) The fee shall be established in the following manner:
(1) Quarterly, beginning October 1, 2009, each health insurer shall pay a fee into the West Virginia Health Information Network Account established in section four, article twenty-nine-g, chapter sixteen. The health insurer may choose either of the following fee options: (A) 0.05 of one percent of all health care claims paid by the health insurer on health insurance for its West Virginia members in the previous fiscal quarter, or
(2) An annual fee payable quarterly, to be calculated on or before August 1, 2009 and on or before August 1 of each succeeding year by the Insurance Commission or by an agent retained by the commission, in consultation with the Governor's Office of Health Enhancement and Lifestyle Planning, based on the proportion which the health insurer's total annual health care claims on health insurance for its West Virginia members for the most recent four quarters of data available to the commission bears to the total health care claims for all health insurers for the most recent four quarters of data available to the commission, multiplied by the total fee revenue which would be raised if all health insurers chose the fee option established in subdivision (1) of this subsection. Such fee shall be subject to an annual recalculation by the Insurance Commission, or an agent retained by the commission, with any surplus or shortfall in the amount collected adjudicated in the following fiscal quarter and bearing no interest or penalty to any party.
(d) It is the intent of the Legislature that all health insurers shall contribute equitably to the West Virginia Health Information Network Account established in section four, article twenty-nine-g, chapter four.
(e) The West Virginia Health Information Network may adopt such legislative rules and issue such orders as are necessary to carry out the purposes of this section.
(f) If any health insurer fails to pay the fee established in subsection (a) of this section within forty-five days after notice from the WVHIN, the Director of WVHIN, or his or her designee, shall notify the Insurance Commission, and the Director of the Governor's Office of Health Enhancement and Lifestyle Planning of the failure to pay. In addition to any other remedy or sanction provided for by law, if the commissioner finds, after notice and an opportunity to be heard, that the health insurer has violated this section or any legislative rule or order adopted or issued pursuant to this section, the commissioner may take any one or more of the following actions:
(1) Assess an administrative penalty on the health insurer of not more than $1,000 for each violation and not more than $10,000 for each willful violation;
(2) Order the health insurer to cease and desist in further violations; or
(3) Order the health insurer to remediate the violation, including the payment of fees in arrears and payment of interest on fees in arrears at the rate of twelve percent per annum.
(g) No later than June 30, 2011, the Director of WVHIN and the Director of the Governor's Office of Health Enhancement and Lifestyle Planning, or his or her designee, shall assess the adequacy of funding and make recommendations to the Legislature and the Governor concerning the appropriateness of the duration of the health care information technology reinvestment fee.
If at any time the Director of the Governor's Office of Health Enhancement and Lifestyle Planning and the Director of WVHIN determine that the assessment set forth in subdivision (c) will produce funds exceeding those necessary to accomplish the purposes of this article due to the availability of federal or other funds for these purposes, the Director of WVHIN shall propose legislation to reduce or eliminate the fee.
(h) This section shall be effective from July 1,2009 through June 30, 2012.

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