H.B. 47
         INSURANCE LAW AMENDMENTS

House Floor Amendments

provide technical assistance in the operations of the pool;
     (f) establish rules, conditions, and procedures for reinsuring risks under this chapter;
     (g) cause the pool to have an annual audit of its operations by the state auditor;
     (h) coordinate with the Department of Health in seeking to obtain from the Centers for Medicare and Medicaid Services, or other appropriate office or agency of government, all appropriate waivers, authority, and permission needed to coordinate the coverage available from the pool with coverage available under Medicaid, either before or after Medicaid coverage, or as a conversion option upon completion of Medicaid eligibility, without the necessity for requalification by the enrollee;
     (i) provide for and employ cost containment measures and requirements including preadmission certification, concurrent inpatient review, and individual case management for the purpose of making the pool more cost-effective;
     (j) offer pool coverage through contracts with health maintenance organizations, preferred provider organizations, and other managed care systems that will manage costs while maintaining quality care;
     (k) establish annual limits on benefits payable under the pool to or on behalf of any enrollee;
     (l) exclude from coverage under the pool specific benefits, medical conditions, and procedures for the purpose of protecting the financial viability of the pool;
     (m) administer the Pool Fund;
     (n) make rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to implement this chapter;