http://www.rapidcityjournal.com/article_9921b66e-2767-11e0-8296-001cc4c03286.html

State legislators have begun the work of complying with the Patient Protection and Affordable Care Act.

In at least two Senate bills being considered in the 2011 Legislative session, technical changes to current state regulations are being considered.

Senate bills 43 and 38, both introduced by the Committee on Commerce, would change state statutes that regulate insurance companies, said Randy Moses of the South Dakota Division of Insurance.

For instance, current state regulations allow insurance companies to charge women a deductible or co-pay for mammogram screenings for breast cancer. The Affordable Care Act requires that insurance companies provide such preventive care free to its clients.

SB43 would make that mandate a state regulation, as well.

“Basically, it does the minimal requirements for the state’s Division of Insurance to comply with the provisions of the federal Health Care Act,” Tom Nelson, R-Lead, said. Nelson is a member of the Commerce Committee.

SB43 moves to comply with the federal mandate allowing young adults up to age 26 to remain on a parent’s insurance policy.

Moses said SB38 would bring the state into compliance by addressing other insurance company practices. For instance, Moses said, currently, if a client applies for precertification for an urgent medical procedure, the insurance company has 72 hours to consider the claim. The Affordable Care Act shortens that to 24 hours, Moses said.

Another major change concerns the appeal process allowed within insurance companies.

Moses said current state law allows insurance clients two internal appeals for cases in which they are denied coverage. Under the Affordable Care Act, companies must allow one internal appeal and an external review by an agency outside the insurance company.

In addition, the law prevents insurance companies from denying coverage for children who have pre-existing conditions. It does not, however, require companies to offer premium breaks for those clients, Moses said.

Moses said the two state bills are mainly housekeeping changes and probably are nothing new to people who have been following the health care reform discussions.

The Patient Protection and Affordable Care Act “changed a lot of requirements around,” Moses said. “These are technical changes we need to make to bring our laws into compliance.”

Contact Lynn Taylor Rick at 394-8414 or lynn.taylorrick@rapidcityjournal.com.

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This entry was posted by cmonfils on Tuesday, January 25th, 2011 at 11:21 am and is filed under Health Care Legislation. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.