wa-law.org > bill > 2023-24 > SB 5581 > Session Law

SB 5581 - Maternal support services

Source

Section 1

  1. The office of the insurance commissioner, in consultation with health carriers, health care providers, and consumers in this state, shall conduct an analysis of how health plans define, cover, and reimburse for maternity care services, including prenatal, delivery, and postpartum care, and make recommendations regarding methods to reduce or eliminate deductibles and other forms of cost sharing for maternity care services.

  2. In conducting the analysis, the office of the insurance commissioner shall:

    1. Obtain necessary information regarding health plans offered by carriers with more than one percent accident and health market share based upon the insurance commissioner's most recent annual market information report and health plans offered to public employees under chapter 41.05 RCW to evaluate:

      1. How health plan benefit designs define maternity care services;

      2. Whether and to what extent maternity care services are subject to deductibles and other cost-sharing requirements;

      3. Which maternity care services are considered preventive services under section 2713 of the federal public health service act (42 U.S.C. Sec. 300gg et seq.) and implementing federal regulations in effect on the effective date of this section and are therefore exempt from cost sharing;

      4. The five most used maternity care reimbursement methodologies used by each carrier; and

    2. With respect to reimbursement methodologies that bundle payment for maternity care services, which specific services are included in the bundled payment;

    3. Estimate the total and per member per month impact on health plan rates of eliminating cost sharing for maternity care services in full, or for prenatal care only, for the following markets:

      1. Individual health plans other than cascade select plans;

      2. Cascade select health plans;

      3. Small group health plans;

      4. Large group health plans;

    4. Health plans offered to public employees under chapter 41.05 RCW; and

    1. All health plans in the aggregate.

  3. The office of the insurance commissioner shall submit a report on the findings and cost estimate to the appropriate committees of the legislature by July 1, 2024. The report must also include recommendations for methods to reduce or eliminate deductibles and other forms of cost sharing for maternity care services.

  4. The office of the insurance commissioner may contract for all or a portion of the analysis required in this section.

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