Introduced by Representatives Grad of Moretown, Martin of Springfield, Ancel of Calais, Brooks of Montpelier, Deen of Westminster, Edwards of Brattleboro, Johnson of South Hero, Kainen of Hartford, Kiss of Burlington, Kitzmiller of Montpelier, Larson of Burlington, Maier of Middlebury, Milkey of Brattleboro, Nuovo of Middlebury and Zuckerman of Burlington
Subject: Banking and insurance; health insurance
Statement of purpose: This bill would allow naturopathic physicians providing treatment within their scope of practice to be reimbursed for providing medically necessary health care services that are covered by a health insurance plan.
AN ACT RELATING TO HEALTH INSURANCE PLAN REIMBURSEMENT FOR COVERED SERVICES PROVIDED BY NATUROPATHIC PHYSICIANS
It is hereby enacted by the General Assembly of the State of Vermont:
Sec. 1. 8 V.S.A. § 4088d is added to read:
§ 4088d. COVERAGE FOR COVERED SERVICES PROVIDED BY
(a) A health insurance plan shall provide coverage for medically necessary health care services covered by the plan when provided by a naturopathic physician licensed in this state for treatment within the scope of practice described in chapter 81 of Title 26. Health care services provided by naturopathic physicians may be subject to reasonable deductibles, co-payment and co-insurance amounts, fee or benefit limits, practice parameters, and utilization review consistent with any applicable regulations published by the department of banking, insurance, securities, and health care administration; provided that any such amounts, limits, and review shall not function to direct treatment in a manner unfairly discriminative against naturopathic care, and collectively shall be no more restrictive than those applicable under the same policy to care or services provided by other health care providers, but allowing for the management of the benefit consistent with variations in practice patterns and treatment modalities among different types of health care providers. Nothing contained herein shall be construed as impeding or preventing either the provision or the coverage of health care services by licensed naturopathic physicians, within the lawful scope of naturopathic practice, in hospital facilities on a staff or employee basis.
(b) As used in this section, “health insurance plan” means any individual or group health insurance policy, any hospital or medical service corporation or health maintenance organization subscriber contract, or any other health benefit plan offered, issued, or renewed for any person in this state by a health insurer, as defined by 18 V.S.A. § 9402(7). The term shall not include benefit plans providing coverage for specific disease or other limited benefit coverage.
The Vermont General Assembly
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