Third Substitute H.B. 218

Representative James A. Dunnigan proposes the following substitute bill:

1 UTAH CHILDREN'S HEALTH INSURANCE PROGRAM
2 2007 GENERAL SESSION
3 STATE OF UTAH
4 Chief Sponsor: James A. Dunnigan
5 Senate Sponsor: ____________
6
7 LONG TITLE
8 General Description:
9 This bill amends the Children's Health Insurance Program.
10 Highlighted Provisions:
11 This bill:
12 . amends the program benefits by July 1, 2008.
13 Monies Appropriated in this Bill:
14 None
15 Other Special Clauses:
16 None
17 Utah Code Sections Affected:
18 AMENDS:
19 26-40-106, as enacted by Chapter 360, Laws of Utah 1998
20
21 Be it enacted by the Legislature of the state of Utah:
22 Section 1. Section 26-40-106 is amended to read:
23 26-40-106. Program benefits.
24 [At a minimum,] (1) Until the department implements a plan under Subsection (2),
25 program benefits [shall] may include:

26 [(1)] (a) hospital services;
27 [(2)] (b) physician services;
28 [(3)] (c) laboratory services;
29 [(4)] (d) prescription drugs;
30 [(5)] (e) mental health services;
31 [(6)] (f) basic dental services;
32 [(7)] (g) preventive care including:
33 [(a)] (i) routine physical examinations;
34 [(b)] (ii) immunizations;
35 [(c)] (iii) basic vision services; and
36 [(d)] (iv) basic hearing services;
37 [(8)] (h) limited home health and durable medical equipment services; and
38 [(9)] (i) hospice care.
39 (2) (a) Except as provided in Subsection (2)(c), no later than July 1, 2008, the program
40 benefits shall be benchmarked, in accordance with 42 U.S.C. 1397cc, to be actuarially
41 equivalent to a benefit plan with the largest insured commercial enrollment offered by a health
42 maintenance organization in the state.
43 (b) Except as provided in Subsection (2)(c), after July 1, 2008:
44 (i) program benefits may not exceed the benefit level described in Subsection (2)(a);
45 and
46 (ii) program benefits shall be adjusted every July 1, thereafter to meet the benefit level
47 described in Subsection (2)(a).
48 (c) The program benefits for enrollees who are at or below 100% of the federal poverty
49 level are exempt from the benchmark requirements of Subsections (2)(a) and (2)(b).