First Substitute H.B. 104

Representative Trisha S. Beck proposes to substitute the following bill:

1 CONSUMER HEALTH CARE STUDY
2 1998 GENERAL SESSION
3 STATE OF UTAH
4 Sponsor: Trisha S. Beck
5 AN ACT RELATING TO STATE COMMISSIONS AND COUNCILS; REQUIRING THE
6 GOVERNOR'S HEALTH POLICY COMMISSION STUDY AND MAKE
7 RECOMMENDATIONS ON HEALTH CARE CONSUMER EDUCATION, INFORMATION,
8 AND ADVOCACY.
9 This act affects sections of Utah Code Annotated 1953 as follows:
10 AMENDS:
11 63C-3-104, as last amended by Chapter 97, Laws of Utah 1997
12 Be it enacted by the Legislature of the state of Utah:
13 Section 1. Section 63C-3-104 is amended to read:
14 63C-3-104. Duties of commission.
15 The Health Policy Commission shall report to the Legislature and the governor on the
16 following issues in accordance with Section 63C-3-101:
17 (1) (a) Each year, the commission may consider and make recommendations on the
18 following:
19 (i) federal health care reform and its impact on the state, including recommendations to
20 respond to federal health initiatives;
21 (ii) proposals for Medicaid reform and federal Medicaid waivers;
22 (iii) evaluation of Medicare and its relationship to Utah's reform;
23 (iv) impact of state initiatives on access, quality, and cost;
24 (v) impact of market structure on competition;
25 (vi) simplification of the administrative process;

1 (vii) feasibility of establishing a statewide health information repository for the purpose
2 of gathering statistical information about providers, practice parameters, cost, quality, and access,
3 while protecting confidential information containing personal identifiers of patients from inclusion
4 in any data base, except a data base created in accordance with Title 26, Chapter 33a, Utah Health
5 Data Authority Act;
6 (viii) review the need for, and revisions to benefit plans;
7 (ix) the impact of federal and state health care reform on the viability of academic health
8 centers in Utah; and
9 (x) other issues that are discovered during the planning process.
10 (b) The commission may change the order in which it considers and makes
11 recommendations on the issues described in Subsections (2) through (8)and may consider other
12 issues as it [deems] considers necessary to promote the purposes of this chapter.
13 (2) By December 1, 1995:
14 (a) advisability of, and if recommended, formation of a purchasing cooperative for
15 individuals and employers with 50 or fewer employees, including structure, membership, costs,
16 benefit plans, and health plan approval criteria;
17 (b) impact of medical savings accounts in the health care market;
18 (c) address special population needs;
19 (d) continue the following insurance reform implementation and refinement:
20 (i) systemwide community rating;
21 (ii) portability;
22 (iii) guaranteed issue; and
23 (iv) risk adjustment mechanism;
24 (e) continue development of the rural health plan, including the study and monitoring of
25 the impact of managed health care plans in frontier areas of the state, and any consequences such
26 plans have on the cost of medical care and access to health care providers in rural-frontier areas
27 of the state;
28 (f) continue development of cost/quality monitoring process; and
29 (g) health care provider education reform emphasizing primary care and financing the
30 health care provider education system.
31 (3) By December 1, 1996:

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1 (a) alternatives to capitated reimbursement;
2 (b) final recommendations for rural health plan; and
3 (c) feasibility of including the following in a benefit plan:
4 (i) alcohol and drug treatment;
5 (ii) long-term care; and
6 (iii) integrating worker's compensation and automobile/health insurance.
7 (4) By December 1, 1997:
8 (a) mental health care reform;
9 (b) long-term care initiatives;
10 (c) advisability of, and if recommended, formation of a purchasing cooperative for the
11 public sector; and
12 (d) advisability of rating health insurance premiums based on lifestyle choices that affect
13 health care expenditures, including the consumption of alcohol or tobacco and other behaviors that
14 increase health risks.
15 (5) By December 1, 1998:
16 (a) feasibility of including Medicaid in a purchasing cooperative;
17 (b) continue development of mental health care reforms; [and]
18 (c) continue review of benefit plans[.]; and
19 (d) study and make recommendations on health care consumer education, information, and
20 advocacy.
21 (6) By December 1, 1999:
22 (a) evaluate the purchasing cooperatives;
23 (b) evaluate the advisability of expanding purchasing cooperative to employers with 50
24 to 100 employees;
25 (c) evaluate need for employer/individual mandates; and
26 (d) evaluate future needs of or for the uninsurable risk pool.
27 (7) By December 1, 2000, a comprehensive report and review on the implementation and
28 effectiveness of the state's health care reform.
29 (8) The issues listed in this section are intended only to be study items for the commission.
30 They do not represent a predetermined final outcome of that study. Any implementation of
31 recommendations resulting from the study remain the prerogative of the Legislature.

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