Around the PIA Western Alliance States – Week of February 5, 2024

Idaho — Unexpected Medical Bills and the No Surprises Act: Market Oversight Bureau Chief Shannon Hohl sat down with KTVB last month to discuss how Idahoans can protect themselves against surprise medical billing. The No Surprises Act is meant to help Idahoans avoid unexpected high medical bills when they receive care from an out of-network provider through no fault of their own. Consumers are encouraged to contact the DOI at 208-334- 4319 or consumeraffairs@doi.idaho.gov with questions about the act or if they are worried they might have been charged too much.

Video: How Idahoans can protect themselves against surprise medical billing

Link: Unexpected Medical Bills and the No Surprises Act

Idaho — Legislature Bills: During the second regular session of the sixty-seventh Idaho legislature, the DOI has nine pending rules that were published in the Idaho Administrative Bulletin 23-12 (beginning on page 49).

These include:

• IDAPA 18.01.02 – Schedule of fees, licenses and miscellaneous charges. This rule provides amounts to be collected for insurance fees, licenses, and miscellaneous charges. One registration fee is reduced, and a registration fee is added for Pharmacy Benefit Managers, which started registering with the Department in 2021.

• IDAPA 18.04.04 – The Managed Care Reform Act rule. This rule implements the Managed Reform Act by defining and establishing operating procedures. Proposed changes are to simplify, clarify, and reduce.

• IDAPA 18.04.08 – Individual and group supplementary disability insurance minimum standards rule. This rule standardizes and simplifies the terms and coverages of individual and group supplementary disability insurance. The changes update and clarify language and broaden the allowable benefit period for disability insurance protection coverage.

• IDAPA 18.06.01 – Rules pertaining to bail agents. This rule sets requirements and procedures relating to bail agents. Changes are to simplify, clarify, and reduce.

• IDAPA 18.06.02 – Producers handling of fiduciary funds. This rule sets allowable fiduciary fund accounts and types, deposits of other funds, account designation, interest, and disbursement of funds. Changes are to simplify, clarify, and reduce.

• IDAPA 18.06.03 – Rules governing disclosure requirements for insurance producers when charging fees. The Department is repealing this rule in its entirety.

• IDAPA 18.07.06 – Rules governing life and health reinsurance agreements. This rule sets standards for reinsurance agreements involving life insurance, annuities, or accident and sickness insurance in order that financial statements properly reflect business of the insurer. Changes are to simplify, clarify, and reduce.

• IDAPA 18.07.10 – Corporate governance annual disclosure. This rule sets procedures for filing and required content of the Corporate Governance Annual Disclosure (CGAD), necessary to carry out the provisions of Title

41, Chapter 64, Idaho Code, and is subject to accreditation review. Changes are to simplify, clarify, and reduce.

• IDAPA 18.08.01 – Adoption of the International Fire Code. This rule adopts the International Fire Code and edits by the State Fire Marshal, such as the minimum standard for the protection of life and property from fire and explosion in the state of Idaho. Changes are to simplify, clarify, and reduce.

Oregon —  To all entities offering health benefit plans in Oregon: The Oregon Division of Financial Regulation has issued a bulletin regarding interim guidance for health benefit plans for Section 20 of 2023 Oregon House Bill 2002 (gender-affirming treatment).

Purpose

The purpose of this bulletin is to provide guidance for health benefit plans regarding coverage of gender-affirming treatment under Section 20 of 2023 Oregon House Bill 2002 until final rules implementing HB 2002 are adopted.

This bulletin is effective upon issuance and applies to carriers offering health benefit plans that are subject to HB 2002 on or after January 1, 2024. The bulletin remains in effect until repealed or until final rules adopted by the Division of Financial Regulation (DFR) to implement HB 2002 become effective, whichever is earlier.

Click here to review this bulletin: https://dfr.oregon.gov/laws-rules/Documents/Bulletins/bulletin2024-02.pdf

Washington — Providence Refunds $158 Million: Providence Health and Services runs 14 hospitals in Washington. The company — according to Washington Attorney General Rob Ferguson — violated the state’s charity care law and overcharged low-income residents.

The company decided rather than go to court, it would settle for $158 million. Of that, $21 million is being returned to some low-income residents and $137 million in outstanding debt is being erased for thousands of others.

This is to settle allegations that Providence used aggressively went after money when bills weren’t paid. Company officials told bill collectors to not accept an answer by people who said they had no money to pay the bill and couldn’t afford to pay.

“Hospitals — especially nonprofits like Providence — get tax breaks and other benefits with the expectation that they are helping everyone have access to affordable health care,” Ferguson said. “When they don’t, they’re taking advantage of the system to their benefit.”

Source link: The Hill — https://bit.ly/488JDak

About PIA Western Alliance

The Professional Insurance Agents Western Alliance is a membership organization promoting and enhancing the success of independent agencies seeking to grow, learn and be heard within the industry.


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