Bills › 89th General Assembly
Related to health insurance coverage for the assessment or diagnosis of a health condition, illness, or disease related to COVID-19, and for the administration of COVID-19 vaccines, and including effective date and retroactive applicability provisions
Where it is now
- Done: IntroducedFebruary 24, 2021
- Stopped: SubcommitteeDied when the General Assembly ended
- Next: House committee
- Next: Passes the House
- Next: Senate committee
- Next: Passes the Senate
- Next: To the Governor
- Next: Signed into law
Died when the session ended The 2022 session adjourned on May 24, 2022, the General Assembly’s last regular session. Bills that didn’t pass both chambers died. What’s a funnel?
What’s in it
This bill relates to health insurance coverage for the assessment or diagnosis of a health condition, illness, or disease related to COVID-19, and for the administration of COVID-19 vaccines. The bill requires policies, contracts, and plans (plans) that provide for third-party payment or prepayment of health or medical expenses to waive all cost-sharing requirements and prior authorization requirements for health care services recommended by a covered person’s health care provider. The plans must also waive all costs, including administration fees and cost-sharing requirements, for the administration of vaccines.
Read the full explanation
“Vaccines” is defined in the bill as any vaccine for COVID-19 licensed by the United States food and drug administration, or for which the United States food and drug administration has issued an emergency use authorization, and that is administered pursuant to guidance issued by federal, state, or county public health officials. In addition, the plans must waive all requirements mandating that a covered person receive health care services in-network if the plan is unable to provide timely and reasonable in-network access to health care services recommended by the covered person’s health care provider, or to vaccines. “Health care services” is defined in the bill as services for the assessment or diagnosis of a health condition, illness, or disease related to COVID-19. The bill prohibits plans from retroactively denying reimbursement, based on a health care provider’s network status or a covered person receiving a diagnosis other than a diagnosis related to COVID-19, to a health care provider that provided health care services or vaccines to a covered person. The bill requires plans to communicate these requirements in writing to all covered persons and to all health care providers that are contracted with the plan. The bill specifies the types of specialized health-related insurance that are not subject to the bill. The commissioner of insurance is required to adopt rules to administer the bill and the rules must include the requirement that all plans adopt a uniform system of billing that allows health care providers to timely process billing codes related to health care services provided to covered persons. The commissioner may also adopt emergency rules as outlined in the bill. The bill takes effect upon enactment and applies retroactively to plans that are delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2020, by the third-party payment providers enumerated in the bill.