HB 796 - Comprehensive Patient Protection Act; enact

Georgia House of Representatives - 1995/1996 Sessions

HB 796 - Comprehensive Patient Protection Act; enact

Page Numbers - 1/ 2/ 3/ 4/ 5/ 6/ 7/ 8/ 9/ 10/ 11/ 12/ 13/ 14
Code Sections - 33-20-40/ 33-20-41/ 33-20-42/ 33-20-43/ 33-20-44/ 33-20-45/ 33-20-46/ 33-20-47/ 33-20-48/ 33-20-49
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House Comm: Ins / Senate Comm: / House Vote: Yeas Nays Senate Vote: Yeas Nays ---------------------------------------- House Action Senate ---------------------------------------- 2/20/95 Read 1st Time 2/21/95 Read 2nd Time ---------------------------------------- Code Sections amended:
HB 796 LC 19 2467 A BILL TO BE ENTITLED AN ACT 1- 1 To amend Chapter 20 of Title 33 of the Official Code of 1- 2 Georgia Annotated, relating to health care plans, so as to 1- 3 enact the "Georgia Comprehensive Patient Protection Act"; to 1- 4 provide for a short title; to provide for legislative 1- 5 findings; to provide for certain definitions; to provide for 1- 6 the authority of the Commissioner of Insurance to establish 1- 7 a process and policies for certification of managed care 1- 8 plans and utilization review programs; to provide for 1- 9 requirements for certification; to provide for certain 1-10 informed decisions about the system of health care delivery 1-11 for patient protection; to provide for physician input into 1-12 medical plans; to provide for credentialing guidelines; to 1-13 provide for qualified utilization review programs; to 1-14 provide for choice requirements of various health plans; to 1-15 provide for other related matters; to provide for 1-16 severability; to repeal conflicting laws; and for other 1-17 purposes. 1-18 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA: SECTION 1. 1-19 Chapter 20 of Title 33 of the Official Code of Georgia 1-20 Annotated, relating to health care plans, is amended by 1-21 designating the current language of said chapter as Article 1-22 1 and by adding at the end thereof a new article, to be 1-23 designated as Article 2, to read as follows: "ARTICLE 2 1-24 33-20-40. (Index) 1-25 This article shall be known and may be cited as the 1-26 'Georgia Comprehensive Patient Protection Act.' 1-27 33-20-41. (Index) 1-28 (a) The General Assembly finds and declares that as the 1-29 health care market becomes increasingly dominated by 1-30 health plans that utilize various managed care techniques 1-31 that include decisions regarding coverage and the -1- (Index) LC 19 2467 2- 1 appropriateness of health care, it is a vital state 2- 2 governmental function to protect patients from unfair 2- 3 managed care practices. Increasingly, insurance companies 2- 4 and other managed care organizations are aggressively 2- 5 terminating highly qualified physicians from their 2- 6 insurance networks of providers, making inappropriate 2- 7 decisions to limit, refuse, or terminate health care and 2- 8 other decisions that negatively affect a patients' health, 2- 9 and restricting patients' ability to make choices 2-10 concerning their health care providers. Consequently, it 2-11 is essential to ensure fairness in managed care plans and 2-12 to provide a mechanism for delineating necessary 2-13 protections for both physicians and their patients. 2-14 (b) The General Assembly declares it necessary for the 2-15 Commissioner of Insurance to establish standards for the 2-16 certification of qualified managed care plans. Standards 2-17 are required to ensure patient protection, physician and 2-18 provider fairness, utilization reviews safeguards, and 2-19 coverage options for all patients, including the ability 2-20 to enroll in a point of service plan. The General 2-21 Assembly declares that patient choice of physicians and 2-22 other providers would be enhanced through the availability 2-23 of a point of service option for those who elect this 2-24 added coverage option. 2-25 33-20-42. (Index) 2-26 As used in this article, the term: 2-27 (1) 'Benefit payment schedule plan' means a health plan 2-28 that: 2-29 (A) Provides coverage for all items and services 2-30 included in the benefit packages that are furnished by 2-31 any lawful health care provider of the enrollee's 2-32 choice, within the scope of state licensure; 2-33 (B) Makes payment for the services of a provider on a 2-34 fee-for-service basis without regard to whether or not 2-35 there is a contractual arrangement between the plan 2-36 and the provider; and 2-37 (C) Provides a benefit payment schedule that 2-38 identifies covered services and the payment for each 2-39 service covered by the plan. No copayments or 2-40 coinsurance shall be applied. The plan shall 2-41 reimburse the enrollee the payment unless the -2- (Index) LC 19 2467 3- 1 individual authorizes direct payment to the provider, 3- 2 which shall be honored by the plan. 3- 3 (2) 'Commissioner' means the Commissioner of Insurance. 3- 4 (3) 'Emergency services' or 'emergency care' means those 3- 5 health care services that are provided in a hospital 3- 6 emergency facility after the sudden onset of a medical 3- 7 condition that manifests itself by symptoms of 3- 8 sufficient severity, including severe pain, so that the 3- 9 absence of immediate medical attention could reasonably 3-10 be expected by a prudent layperson, who possesses an 3-11 average knowledge of health and medicine, to result in: 3-12 (A) Placing the patient's health in serious jeopardy; 3-13 (B) Serious impairment to bodily functions; or 3-14 (C) Serious dysfunction of any bodily organ or part. 3-15 (4) 'Managed care contractor' means a person that: 3-16 (A) Establishes, operates, or maintains a network of 3-17 participating providers; 3-18 (B) Conducts or arranges for utilization review 3-19 activities; and 3-20 (C) Contracts with an insurance company, a hospital or 3-21 medical service plan, an employer, an employee 3-22 organization, or any other entity providing coverage 3-23 for health care services to operate a managed care 3-24 plan. 3-25 (5) 'Managed care entity' includes a licensed insurance 3-26 company, hospital or medical service plan, health 3-27 maintenance organization, an employer or employee 3-28 organization, or a managed care contractor, as defined 3-29 in paragraph (4) of this Code section, that operates a 3-30 managed care plan. 3-31 (6) 'Managed care plan' means a plan operated by a 3-32 managed care entity, as defined in paragraph (5) of this 3-33 Code section, that provides for the financing and 3-34 delivery of health care services to persons enrolled in 3-35 such plan through: 3-36 (A) Arrangements with selected providers to furnish 3-37 health care services; 3-38 (B) Explicit standards for the selection of 3-39 participating providers; -3- (Index) LC 19 2467 4- 1 (C) Organizational arrangements for ongoing quality 4- 2 assurance, utilization review programs, and dispute 4- 3 resolution; and 4- 4 (D) Financial incentives for persons enrolled in the 4- 5 plan to use the participating providers and procedures 4- 6 provided for by the plan. 4- 7 (7) 'Out-of-network' or 'point of service' plan provides 4- 8 additional coverage or access of care to non-network 4- 9 providers to an eligible enrollee of a health plan that 4-10 restricts access to items and services provided by a 4-11 health care provider who is not a member of the plan's 4-12 provider network or coverage of any other services the 4-13 enrollee seeks, whether such services are provided in or 4-14 outside of the enrollee's plan. 4-15 (8) 'Physician' means any person licensed to engage in 4-16 the practice of medicine as defined in Chapter 34 of 4-17 Title 43. 4-18 (9) 'Physician incentive plan' means any compensation 4-19 arrangement between the plan and a physician or 4-20 physician group that may directly or indirectly have the 4-21 effect of reducing or limiting services provided with 4-22 respect to individuals enrolled in the plan. 4-23 (10) 'Provider network' means, with respect to a health 4-24 plan that restricts access, those providers who have 4-25 entered into a contract or agreement with the plan under 4-26 which such providers are obligated to provide items and 4-27 services in the benefits package to eligible individuals 4-28 enrolled in the plan or who have an agreement to provide 4-29 services on a fee-for-service basis. 4-30 (11) 'Qualified managed care plan' means a managed care 4-31 plan that the Commissioner certifies, upon application 4-32 by the program, as meeting the requirements of this 4-33 article. 4-34 (12) 'Qualified utilization review program' means a 4-35 utilization review program that the Commissioner 4-36 certifies, upon application by the program, as meeting 4-37 the requirements of this article. 4-38 (13) 'Utilization review program' means a reasonable 4-39 description of the standards, criteria, policies, 4-40 procedures, reasonable target review periods, and 4-41 reconsideration and appeal mechanisms governing -4- (Index) LC 19 2467 5- 1 utilization review activities performed by a private 5- 2 review agent. 5- 3 33-20-43. (Index) 5- 4 No provision in this article shall be construed as 5- 5 prohibiting: 5- 6 (1) An individual from purchasing any health care 5- 7 services with that individual's own funds, whether such 5- 8 services are covered within the individual's benefit 5- 9 package or from another health care provider or plan; or 5-10 (2) Employers from providing coverage for benefits in 5-11 addition to the comprehensive benefit package. 5-12 33-20-44. (Index) 5-13 (a) The Commissioner shall establish a process for 5-14 certification of managed care plans meeting the 5-15 requirements of Code Section 33-20-45 and of utilization 5-16 review programs meeting the requirements of Code Section 5-17 33-20-46. 5-18 (b) The Commissioner shall establish procedures for the 5-19 periodic review and recertification of qualified managed 5-20 care plans and qualified utilization review programs. 5-21 (c) The Commissioner shall terminate the certification of 5-22 a previously qualified managed care plan or a qualified 5-23 utilization review program if the Commissioner determines 5-24 that such plan or program no longer meets the applicable 5-25 requirements for certification. Before effecting a 5-26 termination, the Commissioner shall provide the plan 5-27 notice and opportunity for a hearing on the proposed 5-28 termination. 5-29 (d) The Commissioner shall establish a process for 5-30 certification through alternative methods provided that: 5-31 (1) An eligible organization, as defined in Section 5-32 1876(b) of the Social Security Act, shall be deemed to 5-33 meet the requirements of subsection (b) of this Code 5-34 section for certification as a qualified managed care 5-35 plan. 5-36 (2) If the Commissioner finds that a national 5-37 accreditation body establishes a requirement or 5-38 requirements for accreditation of a managed care plan or 5-39 utilization review program that are at least equivalent 5-40 to the requirements established under Code Section -5- (Index) LC 19 2467 6- 1 33-20-45, the Commissioner may, to the extent 6- 2 appropriate, treat a managed care plan or a utilization 6- 3 review program thus accredited as meeting the 6- 4 requirements of Code Section 33-20-45. 6- 5 33-20-45. (Index) 6- 6 (a) The Commissioner shall establish standards for the 6- 7 certification of qualified managed care plans that conduct 6- 8 business in this state, including standards whereby 6- 9 prospective enrollees in health insurance plans must be 6-10 provided information as to the terms and conditions of the 6-11 plan so that they can make informed decisions about 6-12 accepting a certain system of health care delivery. A 6-13 plan that is described orally to enrollees must be 6-14 described in terms that are easily understood, truthful, 6-15 and objective. All written plan descriptions must be in a 6-16 readable and understandable format, consistent with 6-17 standards developed for supplemental insurance coverage 6-18 under Title XVIII of the Social Security Act. This format 6-19 shall be standardized so that customers can compare the 6-20 attributes of the plans. Specific items that must be 6-21 included are: 6-22 (1) Coverage provisions, benefits, and any exclusions by 6-23 category of service, provider or physician, including, 6-24 but not limited to, information that reputable 6-25 physicians who are in good standing have the right to 6-26 become a participating physician or health care provider 6-27 for medical or surgical care, or both, as the case may 6-28 be, under such terms or conditions as are imposed on 6-29 other participating physician or approved health care 6-30 providers, and if applicable, by specific service; 6-31 (2) Any and all prior authorization or other review 6-32 requirements including pre-authorization review, 6-33 concurrent review, post-service review, post payment 6-34 review and any procedures that may lead the patient to 6-35 be denied coverage for or not be provided a particular 6-36 service; 6-37 (3) Financial arrangements or contractual provisions 6-38 with hospitals, review companies, physicians or any 6-39 other provider of health care services that would limit 6-40 the services offered, restrict referral or treatment 6-41 options, or negatively affect the physician's fiduciary 6-42 responsibility to his or her patients, including but not -6- (Index) LC 19 2467 7- 1 limited to financial incentives not to provide medical 7- 2 or other services; 7- 3 (4) Explanation of how plan limitations impact 7- 4 enrollees, including information on enrollee financial 7- 5 responsibility for payment for coinsurance or other 7- 6 noncovered or out-of-plan services; 7- 7 (5) Loss ratios; and 7- 8 (6) Enrollee satisfaction statistics, including percent 7- 9 of re-enrollment, reasons for leaving plan, and other 7-10 relevant matters affecting enrollment. 7-11 (b) Plans must demonstrate that they have adequate access 7-12 to physicians and other providers, so that all covered 7-13 health care services will be provided in a timely fashion. 7-14 This requirement cannot be waived and must be met in all 7-15 areas where the plan has enrollees, including rural areas. 7-16 (c) Plans must meet financial reserve requirements as 7-17 established by subsection (b) of Code Section 33-21-10 to 7-18 ensure proper payment for covered services provided. 7-19 (d) All plans shall be required to establish a mechanism, 7-20 with defined rights, under which physicians licensed to 7-21 practice medicine in this state and participating in the 7-22 plan provide input into the plan's medical policy, 7-23 including coverage of new technology and procedures, 7-24 utilization review criteria and procedures, quality and 7-25 credentialing criteria, and medical management procedures. 7-26 (e)(1) All plans shall be required to credential 7-27 physicians within the plan and will allow all physicians 7-28 within the plan's geographic service area to apply for 7-29 such credentials. At least once per year, plans shall 7-30 notify physicians of the opportunity to apply for 7-31 credentials. 7-32 (2) Such a credentialing process shall begin upon 7-33 application of a physician to the plan for inclusion. 7-34 (3) Each application shall be reviewed by a 7-35 credentialing committee with appropriate representation 7-36 of the applicant's medical specialty by persons who are 7-37 actively practicing medicine in this state. 7-38 (4) Credentialing shall be based on objective standards 7-39 of quality with input from physicians credentialed in 7-40 the plan who are actively practicing medicine in this 7-41 state, and such standards shall be available to -7- (Index) LC 19 2467 8- 1 applicants and enrollees. When economic considerations 8- 2 are part of the decision, objective criteria must be 8- 3 used and must be available to applicants, participating 8- 4 physicians, and enrollees. Any economic profiling of 8- 5 physicians must be adjusted to recognize case mix, 8- 6 severity of illness, age of patients, and other features 8- 7 of a physician's practice that may account for higher 8- 8 than or lower than expected costs. Profiles must be 8- 9 made available to those so profiled. When graduate 8-10 medical education is a consideration in credentialing, 8-11 equal recognition will be given to training programs 8-12 accredited by the Accrediting Council on Graduate 8-13 Medical Education and by the American Osteopathic 8-14 Association. 8-15 (5) Plans shall be prohibited from discriminating 8-16 against enrollees with expensive medical conditions by 8-17 excluding practitioners with practices containing a 8-18 substantial number of such patients. 8-19 (6) All decisions shall be made on the record, and the 8-20 applicant shall be provided with all reasons used if the 8-21 application is denied or the contract not renewed. 8-22 (7) Plans shall not be allowed to include clauses in 8-23 physician or other provider contracts that allow for the 8-24 plan to terminate the contract 'without cause.' 8-25 (8) There shall be a due process appeal from all adverse 8-26 decisions. The Commissioner shall establish due process 8-27 appeal mechanism that provides the physician with 8-28 adequate notice and an opportunity for a hearing. A 8-29 plan is deemed to have met the adequate notice and 8-30 hearing requirement of this subsection when the 8-31 physician has been given notice stating: 8-32 (A) That a professional review action has been 8-33 proposed to be taken against the physician; 8-34 (B) Reasons for the proposed action; 8-35 (C) That the physician has the right to request a 8-36 hearing on the proposed action; 8-37 (D) Any time limit, of not less than 30 days, within 8-38 which to request such a hearing; and 8-39 (E) A summary of the rights in the hearing under 7o paragraph (10) of this subsection. -8- (Index) LC 19 2467 9- 1 (9) If a hearing is requested on a timely basis under 9- 2 paragraph (8) of this subsection, the physician involved 9- 3 must be given notice stating: 9- 4 (A) The place, time, and date of the hearing, which 9- 5 date shall not be less than 30 days after the date of 9- 6 the notice; and 9- 7 (B) A list of the witnesses, if any, expected to 9- 8 testify at the hearing on behalf of the professional 9- 9 review body. 9-10 (10) If a hearing is requested on a timely basis under 9-11 paragraph (8) of this subsection: 9-12 (A) Subject to subparagraph (B) of this paragraph, the 9-13 hearing shall be held as determined by the health care 9-14 entity: 9-15 (i) Before an arbitrator mutually acceptable to the 9-16 physician and the health care entity; 9-17 (ii) Before a hearing officer who is appointed by 9-18 the commissioner and who is not in direct economic 9-19 competition with the physician involved; or 9-20 (iii) Before a panel of individuals who are 9-21 acceptable to the physician and the entity and are 9-22 not in direct economic competition with the 9-23 physician involved; 9-24 (B) The right to the hearing may be forfeited if the 9-25 physician fails, without good cause, to appear; 9-26 (C) In the hearing the physician involved has the 9-27 right: 9-28 (i) To representation by an attorney or other person 9-29 of the physician's choice; 9-30 (ii) To have a record made of the proceedings, 9-31 copies of which may be obtained by the physician 9-32 upon payment of any reasonable charges associated 9-33 with the preparation thereof; 9-34 (iii) To call, examine, and cross-examine witnesses; 9-35 (iv) To present evidence determined to be relevant 9-36 by the hearing officer, regardless of its 9-37 admissibility in a court of law; and 9-38 (v) To submit a written statement at the close of 9-39 the hearing; and -9- (Index) LC 19 2467 10- 1 (D) Upon completion of the hearing, the physician 10- 2 involved has the right: 10- 3 (i) To receive the written recommendation of the 10- 4 arbitrator, officer, or panel, including a statement 10- 5 of the basis for the recommendations; and 10- 6 (ii) To receive a written decision of the health 10- 7 care entity, including a statement of the basis for 10- 8 the decision. 10- 9 (11) The same standards and procedures used for an 10-10 application for credentials shall also be used in those 10-11 cases where the plan seeks to reduce or withdraw such 10-12 credentials. Prior to initiation of a proceeding 10-13 leading to termination of a contract 'for cause,' the 10-14 physician shall be provided notice, an opportunity for 10-15 discussion, and an opportunity to enter into and 10-16 complete a corrective action plan, except in cases where 10-17 there is imminent harm to patient health or an action by 10-18 a state medical board or other government agency that 10-19 effectively impairs the physician's ability to practice 10-20 medicine within the jurisdiction. 10-21 (f) Procedures shall be established to ensure that all 10-22 applicable federal and state laws designed to protect the 10-23 confidentiality of provider and individual medical records 10-24 are followed. 10-25 33-20-46. (Index) 10-26 The Commissioner shall establish standards for the 10-27 certification of qualified utilization review programs. 10-28 All plans must have a medical director responsible for all 10-29 clinical decisions by the plan and provide assurances that 10-30 the medical review or utilization practices they use, and 10-31 the medical review or utilization practices of payers or 10-32 reviewers with whom they contract, comply with the 10-33 following requirements: 10-34 (1) Screening criteria, weighting elements, and computer 10-35 algorithms utilized in the review process and their 10-36 method of development must be released to physicians and 10-37 the public; 10-38 (2) Such criteria must be based on sound scientific 10-39 principles and developed in cooperation with practicing 10-40 physicians and other affected health care providers; -10- (Index) LC 19 2467 11- 1 (3) Any person who recommends denial of coverage or 11- 2 payment or determines that a service should not be 11- 3 provided, based on medical necessity standards, must be 11- 4 of the same medical branch (allopathic or osteopathic 11- 5 medicine) and specialty (specialties as recognized by 11- 6 the American Board of Medical Specialties or the 11- 7 American Osteopathic Association) as the practitioner 11- 8 who provided the service; 11- 9 (4) Each claimant or provider, upon assignment of a 11-10 claimant, who has had a claim denied as not medically 11-11 necessary must be provided an opportunity for a due 11-12 process appeal to a medical consultant or peer review 11-13 group not involved in the organization that performed 11-14 the initial review; 11-15 (5) Any individual making a negative judgment or 11-16 recommendation about the necessity or appropriateness of 11-17 services or the site of service must be a physician 11-18 licensed to practice medicine in this state; 11-19 (6) Upon request, physicians will be provided the names 11-20 and credentials of all individuals conducting medical 11-21 necessity or appropriateness review, subject to 11-22 reasonable safeguards and standards; 11-23 (7) Prior authorization is not required for emergency 11-24 care including a medical screening exam and stabilizing 11-25 treatment as defined in Section 1867 of the Social 11-26 Security Act. Any prior authorization requirement for 11-27 medically necessary services arising from such screening 11-28 exam or stabilizing treatment shall be deemed to be 11-29 approved unless a required request is responded to 11-30 within two hours. Other patient or physician requests 11-31 for prior authorization of a nonemergency service must 11-32 be answered within two business days, and qualified 11-33 personnel must be available for same-day telephone 11-34 responses to inquiries about medical necessity, 11-35 including certification of continued length of stay; 11-36 (8) Plans must ensure that enrollees, in plans where 11-37 prior authorization is a condition to coverage of 11-38 service, are required to sign medical information 11-39 release consent forms upon enrollment for use where 11-40 services requiring prior authorization are recommended 11-41 or proposed by their physician; 11-42 (9) When prior approval for a service or other covered 11-43 item is obtained, it shall be considered approval for -11- (Index) LC 19 2467 12- 1 all purposes, and the service shall be considered to be 12- 2 covered unless there was fraud or incorrect information 12- 3 provided at the time such prior approval was obtained; 12- 4 and 12- 5 (10) Procedures shall be established to ensure that all 12- 6 applicable federal and state laws designed to protect 12- 7 the confidentiality of provider and individual medical 12- 8 records are followed. 12- 9 33-20-47. (Index) 12-10 (a) Standards shall first be established under this 12-11 subsection by not later than 12 months after the date of 12-12 the enactment of this subsection. In developing standards 12-13 under this subsection, the Commissioner shall: 12-14 (1) Review standards in use by national private 12-15 accreditation organizations and the National Association 12-16 of Insurance Commissioners; 12-17 (2) Recognize, to the extent appropriate, differences in 12-18 the organizational structure and operation of managed 12-19 care plans; and 12-20 (3) Establish procedures for the timely consideration of 12-21 applications for certification by managed care plans and 12-22 utilization review programs. 12-23 (b) The Commissioner shall periodically review the 12-24 standards established under this subsection and may revise 12-25 the standards from time to time to ensure that such 12-26 standards continue to reflect appropriate policies and 12-27 practices for the cost-effective and medically appropriate 12-28 use of services within managed care plans and utilization 12-29 review programs. 12-30 33-20-48. (Index) 12-31 (a) Each sponsor of a health benefit plan that restricts 12-32 access to providers, including such plans provided, 12-33 offered, or made available by voluntary health purchasing 12-34 cooperatives, employers, and self-insurers, shall offer to 12-35 all eligible enrollees the opportunity to obtain coverage 12-36 for out-of-network services through a 'point of service' 12-37 plan at the time of enrollment and at least for a 12-38 continuous one-month period annually thereafter. 12-39 (b) A plan may charge an enrollee who opts to obtain point 12-40 of service coverage an alternative premium that takes into 12-41 account the actuarial value of such coverage. -12- (Index) LC 19 2467 13- 1 (c) A point of service plan may require payment of 13- 2 coinsurance for an out-of-network item or service, as 13- 3 follows: 13- 4 (1) The applicable coinsurance percentage shall not be 13- 5 greater than 20 percent of payment for items and 13- 6 services; and 13- 7 (2) The applicable coinsurance percentage may be applied 13- 8 differentially with respect to out-of-network items and 13- 9 services. 13-10 (d) All sponsors of point of service plans and physicians 13-11 participating in such plans shall be required to disclose 13-12 their fees, applicable payment schedules, coinsurance 13-13 requirements, or any other financial requirements that 13-14 affect patient payment levels. 13-15 (e) Any enrollee, including enrolled dependents whose 13-16 income does not exceed 200 percent of the established 13-17 federal poverty guideline for the applicable year, shall 13-18 be charged no more than the amount allowed under 13-19 applicable plan limits. Such amount, except for 13-20 reasonable coinsurance, shall be considered payment in 13-21 full. 13-22 33-20-49. (Index) 13-23 (a) Each sponsor of a health benefit plan who offers, 13-24 provides, or makes available such benefit plan, including 13-25 voluntary health insurance purchasing cooperatives, 13-26 employers, and self-insurers must provide to each eligible 13-27 enrollee a choice of health plans among available plans. 13-28 (b) Each voluntary health insurance purchasing 13-29 cooperative, employer, or other sponsor shall include 13-30 among its health plan offerings at least one of each of 13-31 the following types of health benefit plans, where 13-32 available: 13-33 (1) A health maintenance organization or preferred 13-34 provider organization; 13-35 (2) A traditional insurance plan; and 13-36 (3) A benefit payment schedule plan." SECTION 2. 13-37 In the event any section, subsection, sentence, clause, or 13-38 phrase of this Act shall be declared or adjudged invalid or 13-39 unconstitutional, such adjudication shall in no manner -13- (Index) LC 19 2467 14- 1 affect the other sections, subsections, sentences, clauses, 14- 2 or phrases of this Act, which shall remain of full force and 14- 3 effect as if the section, subsection, sentence, clause, or 14- 4 phrase so declared or adjudged invalid or unconstitutional 14- 5 were not originally a part hereof. The General Assembly 14- 6 declares that it would have passed the remaining parts of 14- 7 this Act if it had known that such part or parts hereof 14- 8 would be declared or adjudged invalid or unconstitutional. SECTION 3. 14- 9 All laws and parts of laws in conflict with this Act are 14-10 repealed. -14- (Index)

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