H.B.
294
HEALTH SYSTEM REFORM AMENDMENTS
House Floor
Amendments
Amendment 2 February 9, 2010 10:56 AM
Representative Bradley G. Last proposes the following amendments:
1. Page 15, Lines 435 through 442 :
435 (2) (a) The commissioner shall promote informed consumer behavior and responsible
436 [
437
438 (i) provide to all enrollees, prior to enrollment in the health benefit plan [
439
440 [
:
(I)
the use
441 of a formulary
{
and
}
;
(II) co-payments and deductibles for prescription drugs; and
(III) requirements for
generic substitution;
442 [
2. Page 15, Line 453 through Page 16, Line 464 :
453 (b) [
454
{
file
}
provide
the
{
written
}
disclosure required
by [this]
455 Subsection (2)(a)(i) [
{
with the commissioner
}
:
456 (i)
in writing to the commissioner:
(A)
upon commencement of operations in the state; and
457
{
(ii
}
(B
) anytime the insurer amends any of the following described in Subsection (2)(a)(i):
458
{
(A
}
(I
) treatment policies;
459
{
(B)
}
(II)
practice standards;
460
{
(C)
}
(III)
restrictions;
461
{
(D)
}
(IV)
coverage limits of the insurer's health benefit plan or health insurance policy; or
462
{
(E)
}
(V)
limitations or exclusions of coverage including a limitation or exclusion for a
463 secondary medical condition related to a limitation or exclusion of the insurer's health
464 insurance plan
; and
(ii) to the enrollee, notice of the change in prescription drug coverage under Subsection (2)(a)(i)(A):
(A) either in writing or through the insurer's website; and
(B) at least 60 days prior to the date of the implementation of the change in prescription drug coverage
.
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hb0294.hfa.02.wpd LRGC cdupont cdupont