|BILL AS INTRODUCED||2007-2008|
Introduced by Senator Miller of Chittenden District, Senator Snelling of Chittenden District and Senator White of Windham District
Subject: Health; insurance; Catamount Health; chiropractic services
Statement of purpose: This bill proposes to mandate that Catamount Health cover clinically necessary chiropractic care, whether provided inside or outside an insurer’s provider network; and to disallow the insurer from forcing doctors of chiropractic to bundle bill for services.
AN ACT RELATING TO CHIROPRACTIC HEALTH INSURANCE COVERAGE
It is hereby enacted by the General Assembly of the State of Vermont:
Sec. 1. 8 V.S.A. § 4080f(c)(4) is amended to read:
(4) To the extent Catamount Health provides coverage for any particular type of health service or for any particular medical condition, it shall cover those health services and conditions when provided by any type of health care professional acting within the scope of practice authorized by law, whether provided by an in-network or out-of-network provider, consistent with the provisions of this subsection, subdivision (1) of this subsection, and applicable regulations published by the department of banking, insurance, securities, and health care administration concerning in-network and out-of-network benefits. Catamount Health may establish a term or condition that places a greater financial burden on an individual for access to treatment by the type of health care professional only if it is related to the efficacy or cost-effectiveness of the type of service.
Sec. 2. 8 V.S.A. § 4080f(f)(5) is amended to read:
(5) A carrier offering Catamount Health shall renegotiate existing contracts with health care professionals as necessary in order to pay the reimbursements provided for in this subsection. A carrier offering Catamount Health may not require a health care professional to accept a bundled rate as part of the reimbursement renegotiation.
The Vermont General Assembly
115 State Street