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H.B. 60 Enrolled

             1     

LEGISLATIVE REVIEW OF HEALTH

             2     
INSURANCE MANDATES

             3     
2008 GENERAL SESSION

             4     
STATE OF UTAH

             5     
Chief Sponsor: James A. Dunnigan

             6     
Senate Sponsor: Kevin T. VanTassell

             7     
             8      LONG TITLE
             9      General Description:
             10          This bill modifies provisions related to the Legislature to clarify review of health
             11      insurance mandates by an interim committee.
             12      Highlighted Provisions:
             13          This bill:
             14          .    modifies the process by which the Business and Labor Interim Committee and
             15      Health and Human Services Interim Committee review health insurance mandates;
             16          .    requires the Insurance Department to take certain actions in relationship to a review;
             17          .    removes provisions related to the legislative auditor general assisting with a review;
             18      and
             19          .    makes technical and conforming amendments.
             20      Monies Appropriated in this Bill:
             21          None
             22      Other Special Clauses:
             23          None
             24      Utah Code Sections Affected:
             25      AMENDS:
             26          36-12-5, as last amended by Laws of Utah 2002, Chapter 65
             27          36-12-15, as last amended by Laws of Utah 2005, Chapter 84
             28     
             29      Be it enacted by the Legislature of the state of Utah:


             30          Section 1. Section 36-12-5 is amended to read:
             31           36-12-5. Duties of interim committees.
             32          (1) Except as otherwise provided by law, each interim committee shall:
             33          (a) receive study assignments by resolution from the Legislature;
             34          (b) receive study assignments from the Legislative Management Committee, created
             35      under Section 36-12-6 ;
             36          (c) place matters on its study agenda after requesting approval of the study from the
             37      Legislative Management Committee, which request, if not disapproved by the Legislative
             38      Management Committee within 30 days of receipt of the request, the interim committee shall
             39      consider it approved and may proceed with the requested study;
             40          (d) request research reports from the professional legislative staff pertaining to the
             41      committee's agenda of study;
             42          (e) investigate and study possibilities for improvement in government services within its
             43      subject area;
             44          (f) accept reports from the professional legislative staff and make recommendations for
             45      legislative action with respect to such reports; and
             46          (g) prepare and recommend to the Legislature a legislative program in response to the
             47      committee's study agenda.
             48          (2) (a) As used in this Subsection (2):
             49          (i) "Health insurance" is as defined in Section 31A-1-301 .
             50          (ii) "Health insurance mandate" means a mandatory obligation with respect to a
             51      coverage, benefit, or provider that, but for Title 31A, Insurance Code, would not be required
             52      for a policy of health insurance.
             53          (iii) "Review committee" means:
             54          (A) the Business and Labor Interim Committee; and
             55          (B) the Health and Human Services Interim Committee.
             56          (b) In addition to the duties established pursuant to Subsection (1), [the Business and
             57      Labor Interim Committee and the Health and Human Services Interim Committee] annually


             58      each review committee shall:
             59          (i) identify [provisions in Title 31A, Insurance Code, that impose a mandatory
             60      obligation on health insurers with respect to coverage, benefits, or providers that have been] the
             61      one or more health insurance mandates listed under Subsection (2)(d) that:
             62          (A) are in effect for five or more years as of May 1; and [have]
             63          (B) have not been reviewed during the previous ten years as of May 1; [and]
             64          (ii) select which of the one or more health insurance mandates identified under
             65      Subsection (2)(b)(i) that the review committee elects to review, subject to the direction of the
             66      Legislative Management Committee [which may divide the provisions between the
             67      committees,]; and
             68          (iii) review [the provisions] a health insurance mandate selected under Subsection
             69      (2)(b)(ii) to determine whether the [provisions] health insurance mandate should be continued,
             70      modified, or repealed[, provided that:].
             71          [(A) any provision in effect for five or more years as of July 1, 2000, shall be reviewed
             72      before November 30, 2005; and]
             73          [(B) any provision enacted after July 1, 2000, shall be reviewed on the fifth year after
             74      enactment.]
             75          [(b)] (c) The review under this Subsection (2) shall include:
             76          (i) the estimated fiscal impact of the [provision] health insurance mandate on state and
             77      private health insurance; and
             78          (ii) the purpose and effectiveness of the [provision] health insurance mandate.
             79          [(c) The committee may request through, and with the approval of, the audit
             80      subcommittee that the legislative auditor general perform, or otherwise assist in the
             81      performance of, the review described in Subsection (2)(b).]
             82          (d) The Insurance Department shall:
             83          (i) provide a list of the health insurance mandates in this state in its annual report; and
             84          (ii) assist in a review if requested by a review committee.
             85          (3) Except as otherwise provided by law, reports and recommendations of the interim


             86      committees shall be completed and made public prior to any legislative session at which the
             87      reports and recommendations are submitted. A copy of the reports and recommendations shall
             88      be mailed to each member or member-elect of the Legislature, to each elective state officer, and
             89      to the state library.
             90          Section 2. Section 36-12-15 is amended to read:
             91           36-12-15. Office of Legislative Auditor General established -- Qualifications --
             92      Powers, functions, and duties.
             93          (1) There is created an Office of Legislative Auditor General as a permanent staff office
             94      for the Legislature.
             95          (2) The legislative auditor general shall be a licensed certified public accountant or
             96      certified internal auditor with at least five years experience in the auditing or public accounting
             97      profession, or the equivalent, prior to appointment.
             98          (3) The legislative auditor general shall appoint and develop a professional staff within
             99      budget limitations.
             100          (4) (a) The Office of the Legislative Auditor General shall exercise the constitutional
             101      authority provided in Article VI, Sec. 33, Utah Constitution.
             102          (b) Under the direction of the legislative auditor general, the office shall:
             103          (i) conduct comprehensive and special purpose audits, examinations, and reviews of any
             104      entity that receives public funds;
             105          (ii) prepare and submit a written report on each audit, examination, or review to the
             106      Legislative Management Committee, the audit subcommittee, and to all members of the
             107      Legislature within 75 days after the audit or examination is completed; and
             108          (iii) as provided in Section 36-24-101 :
             109          (A) monitor all new programs and agencies created during each Annual General Session
             110      or Special Session of the Legislature;
             111          (B) provide each new program and agency created with a list of best practices in setting
             112      up their program or agency, including:
             113          (I) policies;


             114          (II) performance measures; and
             115          (III) data collection;
             116          (C) send each new program and agency:
             117          (I) within one year after its creation, a survey instrument requesting a self evaluation
             118      that includes policies, performance measures, and data collection; and
             119          (II) within two years after its creation, a survey instrument requesting a self evaluation
             120      that includes policies, performance measures, and data collection; and
             121          (D) (I) using the new program or agency's response to the self evaluation survey
             122      instruments, recommend to the legislative audit subcommittee that the office conduct an audit of
             123      those new programs and agencies created on which questions have arisen as a result of the
             124      response to the survey instrument and provide a limited scope audit report on those new
             125      programs or agencies on which it receives direction to audit to the legislative interim committee
             126      and to the legislative appropriations subcommittee with oversight responsibility for that
             127      program or agency on or before the November interim meeting; and
             128          (II) include within this limited scope audit report a recommendation as to whether the
             129      program or agency is fulfilling its statutory guidelines and directives.
             130          (5) The audit, examination, or review of any entity that receives public funds may
             131      include a determination of any or all of the following:
             132          (a) the honesty and integrity of all its fiscal affairs;
             133          (b) the accuracy and reliability of its financial statements and reports;
             134          (c) whether or not its financial controls are adequate and effective to properly record
             135      and safeguard its acquisition, custody, use, and accounting of public funds;
             136          (d) whether or not its administrators have faithfully adhered to legislative intent;
             137          (e) whether or not its operations have been conducted in an efficient, effective, and cost
             138      efficient manner;
             139          (f) whether or not its programs have been effective in accomplishing intended
             140      objectives; and
             141          (g) whether or not its management control and information systems are adequate and


             142      effective.
             143          (6) The Office of Legislative Auditor General may:
             144          (a) (i) notwithstanding any other provision of law, obtain access to all records,
             145      documents, and reports of any entity that receives public funds that are necessary to the scope
             146      of its duties; and
             147          (ii) if necessary, issue a subpoena to obtain access as provided in Subsection (6)(a)(i)
             148      using the procedures contained in Title 36, Chapter 14, Legislative Subpoena Powers;
             149          (b) establish policies, procedures, methods, and standards of audit work for the office
             150      and staff;
             151          (c) prepare and submit each audit report without interference from any source relative
             152      to the content of the report, the conclusions reached in the report, or the manner of disclosing
             153      the results of his findings; and
             154          (d) prepare and submit the annual budget request for the office.
             155          (7) To preserve the professional integrity and independence of the office:
             156          (a) no legislator or public official may urge the appointment of any person to the office;
             157      and
             158          (b) the legislative auditor general may not be appointed to serve on any board,
             159      authority, commission, or other agency of the state during his term as legislative auditor
             160      general.
             161          (8) The following records in the custody or control of the legislative auditor general
             162      shall be protected records under Title 63, Chapter 2, Government Records Access and
             163      Management Act:
             164          (a) Records that would disclose information relating to allegations of personal
             165      misconduct, gross mismanagement, or illegal activity of a past or present governmental
             166      employee if the information or allegation cannot be corroborated by the legislative auditor
             167      general through other documents or evidence, and the records relating to the allegation are not
             168      relied upon by the legislative auditor general in preparing a final audit report.
             169          (b) Records and audit workpapers to the extent they would disclose the identity of a


             170      person who during the course of a legislative audit, communicated the existence of any waste of
             171      public funds, property, or manpower, or a violation or suspected violation of a law, rule, or
             172      regulation adopted under the laws of this state, a political subdivision of the state, or any
             173      recognized entity of the United States, if the information was disclosed on the condition that the
             174      identity of the person be protected.
             175          (c) Prior to the time that an audit is completed and the final audit report is released,
             176      records or drafts circulated to a person who is not an employee or head of a governmental
             177      entity for their response or information.
             178          (d) Records that would disclose an outline or part of any audit survey plans or audit
             179      program.
             180          (e) Requests for audits, if disclosure would risk circumvention of an audit.
             181          (f) The provisions of Subsections (8)(a), (b), and (c) do not prohibit the disclosure of
             182      records or information that relate to a violation of the law by a governmental entity or employee
             183      to a government prosecutor or peace officer.
             184          (g) The provisions of this section do not limit the authority otherwise given to the
             185      legislative auditor general to classify a document as public, private, controlled, or protected
             186      under Title 63, Chapter 2, Government Records Access and Management Act.
             187          (9) The legislative auditor general shall:
             188          (a) be available to the Legislature and to its committees for consultation on matters
             189      relevant to areas of [his] the legislative auditor general's professional competence [and shall
             190      perform, or otherwise assist in the performance of, a health insurance provision review as
             191      provided in Section 36-12-5 ];
             192          (b) conduct special audits as requested by the Legislative Management Committee;
             193          (c) report immediately in writing to the Legislative Management Committee through its
             194      audit subcommittee any apparent violation of penal statutes disclosed by the audit of a state
             195      agency and furnish to the Legislative Management Committee all information relative to the
             196      apparent violation;
             197          (d) report immediately in writing to the Legislative Management Committee through its


             198      audit subcommittee any apparent instances of malfeasance or nonfeasance by a state officer or
             199      employee disclosed by the audit of a state agency; and
             200          (e) make any recommendations to the Legislative Management Committee through its
             201      audit subcommittee with respect to the alteration or improvement of the accounting system used
             202      by any entity that receives public funds.
             203          (10) (a) Prior to each annual general session, the legislative auditor general shall
             204      prepare a summary of the audits conducted and of actions taken based upon them during the
             205      preceding year.
             206          (b) This report shall also set forth any items and recommendations that are important
             207      for consideration in the forthcoming session, together with a brief statement or rationale for
             208      each item or recommendation.
             209          (c) The legislative auditor general shall deliver the report to the Legislature and to the
             210      appropriate committees of the Legislature.
             211          (11) (a) No person or entity may:
             212          (i) interfere with a legislative audit, examination, or review of any entity conducted by
             213      the office; or
             214          (ii) interfere with the office relative to the content of the report, the conclusions reached
             215      in the report, or the manner of disclosing the results and findings of the office.
             216          (b) Any person or entity that violates the provisions of this Subsection (11) is guilty of a
             217      class B misdemeanor.


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