Download Zipped Enrolled WordPerfect HB0459.ZIP
[Introduced][Amended][Status][Bill Documents][Fiscal Note][Bills Directory]

---

H.B. 459 Enrolled

             1     

HEALTH AMENDMENTS
             2      2010 GENERAL SESSION
             3      STATE OF UTAH
             4      Chief Sponsor: David Clark
             5      Senate Sponsor: Wayne L. Niederhauser
             6     
             7      LONG TITLE
             8      General Description:
             9          This bill amends provisions related to transparency and health benefits in the Insurance
             10      Code and the Medicaid program.
             11      Highlighted Provisions:
             12          This bill:
             13          .    requires accountability and transparency from the state Medicaid program;
             14          .    requires an insurer to provide information to consumers regarding health insurance
             15      policies; and
             16          .    requires greater choice of benefit plans for employers in the defined contribution
             17      market of the health insurance exchange.
             18      Monies Appropriated in this Bill:
             19          None
             20      Other Special Clauses:
             21          This bill provides an effective date.
             22          This bill coordinates with H.B. 294, Health System Reform Amendments, by
             23      substantively superseding a provision.
             24          This bill coordinates with H.B. 39, Insurance Related Amendments, by providing
             25      substantive changes.
             26      Utah Code Sections Affected:
             27      AMENDS:
             28          26-18-2.3, as last amended by Laws of Utah 2006, Chapter 46
             29          26-18-3, as last amended by Laws of Utah 2008, Chapters 62 and 382

---

             30          31A-22-613.5, as last amended by Laws of Utah 2009, Chapter 12
             31          31A-22-722.5, as enacted by Laws of Utah 2009, Chapter 274
             32          31A-30-205, as enacted by Laws of Utah 2009, Chapter 12
             33      Utah Code Sections Affected by Coordination Clause:
             34          31A-22-613.5, as last amended by Laws of Utah 2009, Chapter 12
             35          31A-22-722.5, as enacted by Laws of Utah 2009, Chapter 274
             36          31A-30-205, as enacted by Laws of Utah 2009, Chapter 12
             37     
             38      Be it enacted by the Legislature of the state of Utah:
             39          Section 1. Section 26-18-2.3 is amended to read:
             40           26-18-2.3. Division responsibilities -- Emphasis -- Periodic assessment.
             41          (1) In accordance with the requirements of Title XIX of the Social Security Act and
             42      applicable federal regulations, the division is responsible for the effective and impartial
             43      administration of this chapter in an efficient, economical manner. The division shall:
             44          (a) establish, on a statewide basis, a program to safeguard against unnecessary or
             45      inappropriate use of Medicaid services, excessive payments, and unnecessary or inappropriate
             46      hospital admissions or lengths of stay;
             47          (b) deny any provider claim for services that fail to meet criteria established by the
             48      division concerning medical necessity or appropriateness; and
             49          (c) place its emphasis on high quality care to recipients in the most economical and
             50      cost-effective manner possible, with regard to both publicly and privately provided services.
             51          (2) The division shall implement and utilize cost-containment methods, where
             52      possible, which may include[, but are not limited to]:
             53          (a) prepayment and postpayment review systems to determine if utilization is
             54      reasonable and necessary;
             55          (b) preadmission certification of nonemergency admissions;
             56          (c) mandatory outpatient, rather than inpatient, surgery in appropriate cases;
             57          (d) second surgical opinions;

---

             58          (e) procedures for encouraging the use of outpatient services;
             59          (f) consistent with Sections 26-18-2.4 and 58-17b-606 , a Medicaid drug program;
             60          (g) coordination of benefits; and
             61          (h) review and exclusion of providers who are not cost effective or who have abused
             62      the Medicaid program, in accordance with the procedures and provisions of federal law and
             63      regulation.
             64          (3) The director of the division shall periodically assess the cost effectiveness and
             65      health implications of the existing Medicaid program, and consider alternative approaches to
             66      the provision of covered health and medical services through the Medicaid program, in order
             67      to reduce unnecessary or unreasonable utilization.
             68          (4) The department shall ensure Medicaid program integrity by conducting internal
             69      audits of the Medicaid program for efficiencies, best practices, fraud, waste, abuse, and cost
             70      recovery, at least in proportion to the percent of funding for the program that comes from state
             71      funds.
             72          (5) The department shall, by December 31 of each year, report to the Health and
             73      Human Services Appropriations Subcommittee regarding:
             74          (a) measures taken under this section to increase:
             75          (i) efficiencies within the program; and
             76          (ii) cost avoidance and cost recovery efforts in the program; and
             77          (b) results of program integrity efforts under Subsection (4).
             78          Section 2. Section 26-18-3 is amended to read:
             79           26-18-3. Administration of Medicaid program by department -- Reporting to the
             80      Legislature -- Disciplinary measures and sanctions -- Funds collected -- Eligibility
             81      standards.
             82          (1) The department shall be the single state agency responsible for the administration
             83      of the Medicaid program in connection with the United States Department of Health and
             84      Human Services pursuant to Title XIX of the Social Security Act.
             85          (2) (a) The department shall implement the Medicaid program through administrative

---

             86      rules in conformity with this chapter, Title 63G, Chapter 3, Utah Administrative Rulemaking
             87      Act, the requirements of Title XIX, and applicable federal regulations.
             88          (b) The rules adopted under Subsection (2)(a) shall include, in addition to other rules
             89      necessary to implement the program:
             90          (i) the standards used by the department for determining eligibility for Medicaid
             91      services;
             92          (ii) the services and benefits to be covered by the Medicaid program; and
             93          (iii) reimbursement methodologies for providers under the Medicaid program.
             94          (3) (a) The department shall, in accordance with Subsection (3)(b), report to either the
             95      Legislative Executive Appropriations Committee or the Legislative Health and Human
             96      Services Appropriations Subcommittee when the department:
             97          (i) implements a change in the Medicaid State Plan;
             98          (ii) initiates a new Medicaid waiver;
             99          (iii) initiates an amendment to an existing Medicaid waiver; [or]
             100          (iv) applies for an extension of an application for a waiver or an existing Medicaid
             101      waiver; or
             102          [(iv)] (v) initiates a rate change that requires public notice under state or federal law.
             103          (b) The report required by Subsection (3)(a) shall:
             104          (i) be submitted to the Legislature's Executive Appropriations Committee or the
             105      legislative Health and Human Services Appropriations Subcommittee prior to the department
             106      implementing the proposed change; and
             107          (ii) [shall] include:
             108          (A) a description of the department's current practice or policy that the department is
             109      proposing to change;
             110          (B) an explanation of why the department is proposing the change;
             111          (C) the proposed change in services or reimbursement, including a description of the
             112      effect of the change;
             113          (D) the effect of an increase or decrease in services or benefits on individuals and

---

             114      families;
             115          (E) the degree to which any proposed cut may result in cost-shifting to more expensive
             116      services in health or human service programs; and
             117          (F) the fiscal impact of the proposed change, including:
             118          (I) the effect of the proposed change on current or future appropriations from the
             119      Legislature to the department;
             120          (II) the effect the proposed change may have on federal matching dollars received by
             121      the state Medicaid program;
             122          (III) any cost shifting or cost savings within the department's budget that may result
             123      from the proposed change; and
             124          (IV) identification of the funds that will be used for the proposed change, including
             125      any transfer of funds within the department's budget.
             126          (4) Any rules adopted by the department under Subsection (2) are subject to review
             127      and reauthorization by the Legislature in accordance with Section 63G-3-502 .
             128          (5) The department may, in its discretion, contract with the Department of Human
             129      Services or other qualified agencies for services in connection with the administration of the
             130      Medicaid program, including:
             131          (a) the determination of the eligibility of individuals for the program;
             132          (b) recovery of overpayments; and
             133          (c) consistent with Section 26-20-13 , and to the extent permitted by law and quality
             134      control services, enforcement of fraud and abuse laws.
             135          (6) The department shall provide, by rule, disciplinary measures and sanctions for
             136      Medicaid providers who fail to comply with the rules and procedures of the program, provided
             137      that sanctions imposed administratively may not extend beyond:
             138          (a) termination from the program;
             139          (b) recovery of claim reimbursements incorrectly paid; and
             140          (c) those specified in Section 1919 of Title XIX of the federal Social Security Act.
             141          (7) Funds collected as a result of a sanction imposed under Section 1919 of Title XIX

---

             142      of the federal Social Security Act shall be deposited in the General Fund as nonlapsing
             143      dedicated credits to be used by the division in accordance with the requirements of Section
             144      1919 of Title XIX of the federal Social Security Act.
             145          (8) (a) In determining whether an applicant or recipient is eligible for a service or
             146      benefit under this part or Chapter 40, Utah Children's Health Insurance Act, the department
             147      shall, if Subsection (8)(b) is satisfied, exclude from consideration one passenger vehicle
             148      designated by the applicant or recipient.
             149          (b) Before Subsection (8)(a) may be applied:
             150          (i) the federal government must:
             151          (A) determine that Subsection (8)(a) may be implemented within the state's existing
             152      public assistance-related waivers as of January 1, 1999;
             153          (B) extend a waiver to the state permitting the implementation of Subsection (8)(a); or
             154          (C) determine that the state's waivers that permit dual eligibility determinations for
             155      cash assistance and Medicaid are no longer valid; and
             156          (ii) the department must determine that Subsection (8)(a) can be implemented within
             157      existing funding.
             158          (9) (a) For purposes of this Subsection (9):
             159          (i) "aged, blind, or disabled" shall be defined by administrative rule; and
             160          (ii) "spend down" means an amount of income in excess of the allowable income
             161      standard that must be paid in cash to the department or incurred through the medical services
             162      not paid by Medicaid.
             163          (b) In determining whether an applicant or recipient who is aged, blind, or disabled is
             164      eligible for a service or benefit under this chapter, the department shall use 100% of the
             165      federal poverty level as:
             166          (i) the allowable income standard for eligibility for services or benefits; and
             167          (ii) the allowable income standard for eligibility as a result of spend down.
             168          Section 3. Section 31A-22-613.5 is amended to read:
             169           31A-22-613.5. Price and value comparisons of health insurance -- Basic Health

---

             170      Care Plan.
             171          (1) (a) [Except as provided in Subsection (1)(b), this] This section applies to all health
             172      [insurance policies and health maintenance organization contracts] benefit plans.
             173          (b) Subsection (2) applies to:
             174          (i) all [health insurance policies and health maintenance organization contracts] health
             175      benefit plans; and
             176          (ii) coverage offered to state employees under Subsection 49-20-202 (1)(a).
             177          (2) (a) The commissioner shall promote informed consumer behavior and responsible
             178      [health insurance and] health benefit plans by requiring an insurer issuing [health insurance
             179      policies or health maintenance organization contracts] a health benefit plan to:
             180          (i) provide to all enrollees, prior to enrollment in the health benefit plan [or health
             181      insurance policy,] written disclosure of:
             182          [(i)] (A) restrictions or limitations on prescription drugs and biologics including:
             183          (I) the use of a formulary [and];
             184          (II) co-payments and deductibles for prescription drugs; and
             185          (III) requirements for generic substitution;
             186          [(ii)] (B) coverage limits under the plan; and
             187          [(iii)] (C) any limitation or exclusion of coverage including:
             188          [(A)] (I) a limitation or exclusion for a secondary medical condition related to a
             189      limitation or exclusion from coverage; and
             190          [(B)] (II) [beginning July 1, 2009,] easily understood examples of a limitation or
             191      exclusion of coverage for a secondary medical condition[.]; and
             192          (ii) provide the commissioner with:
             193          (A) the information described in Subsections 63M-1-2506 (3) through (6) in the
             194      standardized electronic format required by Subsection 63M-1-2506 (1); and
             195          (B) information regarding insurer transparency in accordance with Subsection (5).
             196          (b) [In addition to the requirements of Subsections (2)(a), (d), and (e) an insurer
             197      described in Subsection (2)(a) shall file the written] An insurer shall provide the disclosure

---

             198      required by [this] Subsection (2)(a)(i) [to the commissioner:] in writing to the commissioner:
             199          (i) upon commencement of operations in the state; and
             200          (ii) anytime the insurer amends any of the following described in Subsection (2)(a)(i):
             201          (A) treatment policies;
             202          (B) practice standards;
             203          (C) restrictions;
             204          (D) coverage limits of the insurer's health benefit plan or health insurance policy; or
             205          (E) limitations or exclusions of coverage including a limitation or exclusion for a
             206      secondary medical condition related to a limitation or exclusion of the insurer's health
             207      insurance plan.
             208          [(c) The commissioner may adopt rules to implement the disclosure requirements of
             209      this Subsection (2), taking into account:]
             210          [(i) business confidentiality of the insurer;]
             211          [(ii) definitions of terms;]
             212          [(iii) the method of disclosure to enrollees; and]
             213          [(iv) limitations and exclusions.]
             214          (c) An insurer shall provide the enrollee with notice of an increase in costs for
             215      prescription drug coverage due to a change in benefit design under Subsection (2)(a)(i)(A):
             216          (i) either:
             217          (A) in writing; or
             218          (B) on the insurer's website; and
             219          (ii) at least 30 days prior to the date of the implementation of the increase in cost, or as
             220      soon as reasonably possible.
             221          (d) If under Subsection (2)(a)(i)(A) a formulary is used, the insurer shall make
             222      available to prospective enrollees and maintain evidence of the fact of the disclosure of:
             223          (i) the drugs included;
             224          (ii) the patented drugs not included;
             225          (iii) any conditions that exist as a precedent to coverage; and

---

             226          (iv) any exclusion from coverage for secondary medical conditions that may result
             227      from the use of an excluded drug.
             228          (e) (i) The department shall develop examples of limitations or exclusions of a
             229      secondary medical condition that an insurer may use under Subsection (2)(a)[(iii)](i)(C).
             230          (ii) Examples of a limitation or exclusion of coverage provided under Subsection
             231      (2)(a)[(iii)](i)(C) or otherwise are for illustrative purposes only, and the failure of a particular
             232      fact situation to fall within the description of an example does not, by itself, support a finding
             233      of coverage.
             234          (3) An insurer who offers a health [care] benefit plan under Chapter 30, Individual,
             235      Small Employer, and Group Health Insurance Act, shall[: (a) until January 1, 2010, offer the
             236      basic health care plan described in Subsection (4) subject to the open enrollment provisions of
             237      Chapter 30, Individual, Small Employer, and Group Health Insurance Act; and (b) beginning
             238      January 1, 2010,] offer a basic health care plan subject to the open enrollment provisions of
             239      Chapter 30, Individual, Small Employer, and Group Health Insurance Act, that:
             240          [(i)] (a) is a federally qualified high deductible health plan;
             241          [(ii)] (b) has [the lowest] a deductible that is within $250 of the lowest deductible that
             242      qualifies under a federally qualified high deductible health plan, as adjusted by federal law;
             243      and
             244          [(iii)] (c) does not exceed an annual out of pocket maximum equal to three times the
             245      amount of the annual deductible.
             246          [(4) Until January 1, 2010, the Basic Health Care Plan under this section shall provide
             247      for:]
             248          [(a) a lifetime maximum benefit per person not less than $1,000,000;]
             249          [(b) an annual maximum benefit per person not less than $250,000;]
             250          [(c) an out-of-pocket maximum of cost-sharing features:]
             251          [(i) including:]
             252          [(A) a deductible;]
             253          [(B) a copayment; and]

---

             254          [(C) coinsurance;]
             255          [(ii) not to exceed $5,000 per person; and]
             256          [(iii) for family coverage, not to exceed three times the per person out-of-pocket
             257      maximum provided in Subsection (4)(c)(ii);]
             258          [(d) in relation to its cost-sharing features:]
             259          [(i) a deductible of:]
             260          [(A) not less than $1,000 per person for major medical expenses; and]
             261          [(B) for family coverage, not to exceed three times the per person deductible for major
             262      medical expenses under Subsection (4)(d)(i)(A); and]
             263          [(ii) (A) a copayment of not less than:]
             264          [(I) $25 per visit for office services; and]
             265          [(II) $150 per visit to an emergency room; or]
             266          [(B) coinsurance of not less than:]
             267          [(I) 20% per visit for office services; and]
             268          [(II) 20% per visit for an emergency room; and]
             269          [(e) in relation to cost-sharing features for prescription drugs:]
             270          [(i) (A) a deductible not to exceed $1,000 per person; and]
             271          [(B) for family coverage, not to exceed three times the per person deductible provided
             272      in Subsection (4)(e)(i)(A); and]
             273          [(ii) (A) a copayment of not less than:]
             274          [(I) the lesser of the cost of the prescription drug or $15 for the lowest level of cost for
             275      prescription drugs;]
             276          [(II) the lesser of the cost of the prescription drug or $25 for the second level of cost
             277      for prescription drugs; and]
             278          [(III) the lesser of the cost of the prescription drug or $35 for the highest level of cost
             279      for prescription drugs; or]
             280          [(B) coinsurance of not less than:]
             281          [(I) the lesser of the cost of the prescription drug or 25% for the lowest level of cost for

---

             282      prescription drugs;]
             283          [(II) the lesser of the cost of the prescription drug or 40% for the second level of cost
             284      for prescription drugs; and]
             285          [(III) the lesser of the cost of the prescription drug or 60% for the highest level of cost
             286      for prescription drugs.]
             287          [(5) The department shall include in its yearly insurance market report information
             288      about:]
             289          [(a) the types of health benefit plans sold on the Internet portal created in Section
             290      63M-1-2504 ;]
             291          [(b) the number of insurers participating in the defined contribution market on the
             292      Internet portal;]
             293          [(c) the number of employers and covered lives in the defined contribution market;
             294      and]
             295          [(d) the number of lives covered by health benefit plans that do not include state
             296      mandates as permitted by Subsection 31A-30-109 (2).]
             297          [(6)] (4) The commissioner:
             298          (a) shall forward the information submitted by an insurer under Subsection (2)(a)(ii) to
             299      the Health Insurance Exchange created under Section 63M-1-2504 ; and
             300          (b) may request information from an insurer to verify the information submitted by the
             301      insurer [to the Internet portal under Subsection 63M-1-2506 (4)] under this section.
             302          (5) The commissioner shall:
             303          (a) convene a group of insurers, a member representing the Public Employees' Benefit
             304      and Insurance Program, consumers, and an organization described in Subsection
             305      31A-22-614.6 (3)(b), to develop information for consumers to compare health insurers and
             306      health benefit plans on the Health Insurance Exchange, which shall include consideration of:
             307          (i) the number and cost of an insurer's denied health claims;
             308          (ii) the cost of denied claims that is transferred to providers;
             309          (iii) the average out-of-pocket expenses incurred by participants in each health benefit

---

             310      plan that is offered by an insurer in the Health Insurance Exchange;
             311          (iv) the relative efficiency and quality of claims administration and other
             312      administrative processes for each insurer offering plans in the Health Insurance Exchange; and
             313          (v) consumer assessment of each insurer or health benefit plan;
             314          (b) adopt an administrative rule that establishes:
             315          (i) definition of terms;
             316          (ii) the methodology for determining and comparing the insurer transparency
             317      information;
             318          (iii) the data, and format of the data, that an insurer must submit to the department in
             319      order to facilitate the consumer comparison on the Health Insurance Exchange in accordance
             320      with Section 63M-1-2506 ; and
             321          (iv) the dates on which the insurer must submit the data to the department in order for
             322      the department to transmit the data to the Health Insurance Exchange in accordance with
             323      Section 63M-1-2506 ; and
             324          (c) implement the rules adopted under Subsection (5)(b) in a manner that protects the
             325      business confidentiality of the insurer.
             326          Section 4. Section 31A-22-722.5 is amended to read:
             327           31A-22-722.5. Mini-COBRA election -- American Recovery and Reinvestment
             328      Act.
             329          (1) [An] (a) If the provisions of Subsection (1)(b) are met, an individual has a right[,
             330      until April 18, 2009,] to contact the individual's employer or the insurer for the employer to
             331      participate in a [second election] transition period for mini-COBRA benefits under Section
             332      31A-22-722 in accordance with Section 3001 of the American Recovery and Reinvestment
             333      Act of 2009 (Pub. S. 111-5) [if the individual:], as amended.
             334          [(a) was] (b) An individual has the right under Subsection (1)(a) if the individual:
             335          (i) was involuntarily terminated from employment [between September 1, 2008 and
             336      February 17, 2009, as defined] during the period of time identified in Section 3001 of the
             337      American Recovery and Reinvestment Act of 2009 (Pub. S. 111-5), as amended;

---

             338          [(b)] (ii) is eligible for COBRA premium assistance under Section 3001 of the
             339      American Recovery and Reinvestment Act of 2009 (Pub. S. 111-5), as amended; [and]
             340          [(c)] (iii) was eligible for Utah mini-COBRA as provided in Section 31A-22-722 at
             341      the time of termination[.];
             342          (iv) elected Utah mini-Cobra; and
             343          (v) voluntarily dropped coverage, which includes dropping coverage through
             344      non-payment of premiums, between December 1, 2009 and February 1, 2010.
             345          (2) (a) An individual or the employer of the individual shall contact the insurer and
             346      inform the insurer that the individual wants to [take advantage of the second election]
             347      maintain coverage and pay retroactive premiums under a transition period for mini-COBRA
             348      coverage [under] in accordance with the provisions of Section 3001 of the American Recovery
             349      and Reinvestment Act of 2009 (Pub. S. 111-5), as amended.
             350          (b) An individual or an employer on behalf of an eligible individual must submit the
             351      [enrollment forms] applicable forms and premiums for coverage under Subsection (1) to the
             352      insurer [prior to May 1, 2009] in accordance with the provisions of Section 3001 of the
             353      American Recovery and Reinvestment Act of 2009 (Pub. S. 11-5), as amended.
             354          (3) [The provision regarding the application of pre-existing condition waivers to the
             355      extended second election period for federal COBRA under Section 3001 of the American
             356      Recovery and Reinvestment Act of 2009 (Pub. S. 111-5) shall apply to the extended second
             357      election for state mini-COBRA under this section.] An insured has the right to extend the
             358      employee's coverage under mini-cobra with the current employer's group policy beyond the 12
             359      months to the period of time the insured is eligible to receive assistance in accordance with
             360      Section 3001 of the American Recovery and Reinvestment Act of 2009 (Pub. S. 111-5) as
             361      amended.
             362          (4) An insurer that violates this section is subject to penalties in accordance with
             363      Section 31A-2-308 .
             364          Section 5. Section 31A-30-205 is amended to read:
             365           31A-30-205. Health benefit plans offered in the defined contribution market.

---

             366          (1) An insurer who [chooses to offer a health benefit plan in the] offers a defined
             367      contribution [market must] arrangement health benefit plan shall offer the following health
             368      benefit plans as defined contribution arrangements:
             369          [(a) one health benefit plan that:]
             370          [(i) is a federally qualified high deductible health plan;]
             371          [(ii) has the lowest deductible permitted for a federally qualified high deductible
             372      health plan as adjusted by federal law; and]
             373          [(iii) does not exceed annual out-of-pocket maximum equal to three times the amount
             374      of the annual deductible; and]
             375          (a) the basic benefit plan;
             376          (b) one health benefit plan with [benefits that have] an aggregate actuarial value at
             377      least 15% greater [that] than the [plan described in Subsection (1)(a).] actuarial value of the
             378      basic benefit plan;
             379          (c) on or before January 1, 2011, one health benefit plan that is a federally qualified
             380      high deductible health plan that has an individual deductible of $2,500 and a deductible of
             381      $5,000 for coverage including two or more individuals, and does not exceed an annual
             382      out-of-pocket maximum equal to three times the amount of the annual deductible;
             383          (d) on or before January 1, 2011, one health benefit plan that is a federally qualified
             384      high deductible health plan that has a deductible that is within $250 of the highest deductible
             385      that qualifies as a federally qualified high deductible health plan as adjusted by federal law,
             386      and does not exceed an annual out-of-pocket maximum equal to three times the amount of the
             387      annual deductible; and
             388          (e) the insurer's five most commonly selected health benefit plans that:
             389          (i) include:
             390          (A) the provider panel;
             391          (B) the deductible;
             392          (C) co-payments;
             393          (D) co-insurance; and

---

             394          (E) pharmacy benefits; and
             395          (ii) are currently being marketed by the carrier to new groups for enrollment.
             396          (2) (a) The provisions of Subsection (1) do not limit the number of defined
             397      contribution arrangement health benefit plans an insurer may offer in the defined contribution
             398      arrangement market.
             399          (b) An insurer who offers the health benefit plans required by Subsection (1) may also
             400      offer any other health benefit plan [in the] as a defined contribution [market] arrangement if:
             401          (i) the health benefit plan provides benefits that are [actuarially richer] of greater
             402      actuarial value than the benefits required in [Subsection (1)(a).] the basic benefit plan; or
             403          (ii) the health benefit plan provides benefits with an aggregate actuarial value that is
             404      no lower than the actuarial value of the plan required in Subsection (1)(c).
             405          Section 6. Effective date.
             406          If approved by two-thirds of all the members elected to each house, this bill takes effect
             407      upon approval by the governor, or the day following the constitutional time limit of Utah
             408      Constitution Article VII, Section 8, without the governor's signature, or in the case of a veto,
             409      the date of veto override.
             410          Section 7. Coordinating H.B. 459 with H.B. 294 -- Superseding amendments.
             411          If this H.B. 459 and H.B. 294, Health System Reform Amendments, both pass, it is the
             412      intent of the Legislature that the amendments to Sections 31A-22-613.5 and 31A-30-205 in
             413      this bill supersede the amendments to Sections 31A-22-613.5 and 31A-30-205 in H.B. 294,
             414      when the Office of Legislative Research and General Counsel prepares the Utah Code
             415      database for publication.
             416          Section 8. Coordinating H.B. 459 with H.B. 39 -- Substantive changes.
             417          If this H.B. 459 and H.B. 39, Insurance Related Amendments, both pass, it is the intent
             418      of the Legislature that the amendments to Section 31A-22-722.5 in this bill supersede the
             419      amendments to Section 31A-22-722.5 in H.B. 39, and has retrospective operation to the date
             420      the governor signed H.B. 39, when the Office of Legislative Research and General Counsel
             421      prepares the Utah Code database for publication.

---

             422     

---

[Bill Documents][Bills Directory]