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(123rd General Assembly)(Substitute House Bill Number 221)
AN ACT
To enact sections 103.144, 103.145, 103.146, and 103.147
of the Revised Code to require, under certain circumstances,
the Legislative Budget Officer to arrange for
independent healthcare actuarial reviews of bills that include a mandated
benefit and to make an appropriation.
Be it enacted by the General Assembly of the State of Ohio:
SECTION 1 . That sections 103.144, 103.145, 103.146,
and 103.147 of the Revised Code be enacted to read as
follows:
Sec. 103.144. As used in sections 103.144 to 103.147 of the
Revised Code: (A) "Mandated benefit" means the following, when
considered in the context of a sickness and accident insurance
policy or a health insuring corporation policy, contract, or
agreement: (1) Any required coverage for a specific medical or
health-related service, treatment, medication, or practice; (2) Any required coverage for the services of specific health
care providers; (3) Any requirement that an insurer or health insuring
corporation offer coverage to specific individuals or groups; (4) Any requirement that an insurer or health insuring
corporation offer specific medical or health-related services, treatments,
medications, or practices
to existing insureds or enrollees; (5) Any required expansion of, or addition to, existing
coverage; (6) Any mandated reimbursement amount to specific health care
providers. (B) "Mandated benefit" does not include any required coverage or
offer of coverage, any required expansion of, or addition to, existing
coverage, or any mandated
reimbursement amount to specific providers, as described in division
(A) of this section, within the context of any public
health benefits arrangement, including but not limited to, the
coverage of beneficiaries enrolled in Title XVIII of the
"Social
Security Act," 49 Stat. 620
(1935), 42 U.S.C.A. 301, as amended,
pursuant to a medicare risk
contract or medicare cost contract, or to the coverage of
beneficiaries enrolled in Title XIX of the "Social
Security
Act," 49
Stat. 620 (1935), 42
U.S.C.A.
301, as amended, known as the medical assistance program or medicaid, provided
by the Ohio department of job and
family services under Chapter
5111. of the Revised Code. Sec. 103.145. (A) Whenever any bill receives a second hearing in
a standing committee in the house of the general assembly in which the bill
originated, the legislative budget officer shall review the bill to determine
whether the bill includes a mandated benefit. If the legislative budget
officer determines that the bill includes a mandated benefit, the legislative
budget officer shall
ARRANGE FOR THE PERFORMANCE OF
AN INDEPENDENT HEALTHCARE ACTUARIAL REVIEW OF THE MANDATED BENEFIT. IN
MAKING THIS ARRANGEMENT, THE legislative budget officer SHALL
retain one or more independent actuaries on a consulting basis to
determine the financial impact of the mandated benefit in
accordance with
section 103.146 of the Revised Code. Each actuary retained
shall be a member in good standing of the American academy of
actuaries. The legislative budget officer shall
assist the
actuary or actuaries in obtaining any information needed. No later than sixty days after the second hearing of the bill, the
legislative budget officer shall submit the findings of the actuarial review
to the chairperson of the committee to which the bill is assigned and to the
ranking minority member of that committee. (B) To assist the actuary or actuaries in obtaining information
needed
to perform the healthcare actuarial review, the legislative
budget office of the legislative service commission may request any
department, division, institution, board,
commission, authority, bureau, or other
instrumentality or officer of the state, a county, a municipal corporation, a
township, a school district, or other
governmental entity of the state to provide any information the
legislative budget office requires for purposes of the review. An instrumentality, officer, or entity shall comply with a
request as soon as reasonably possible after receiving it. The
legislative budget office shall specify the manner of compliance, and the
period of time for compliance, in its request. Sec. 103.146. In performing an independent healthcare actuarial review of
a
mandated benefit, the
actuary or actuaries retained by the legislative budget officer shall consult
with
professionals KNOWLEDGEABLE IN MATTERS RELATED TO THE PERFORMANCE
OF AN ACTUARIAL REVIEW OF A MANDATED BENEFIT
and shall consider the results of any professionally
acceptable controlled trial and any other relevant
research specifically centered around the benefit. The actuary
or actuaries shall determine the extent to which: (A) The mandated benefit will increase or decrease the
administrative
expenses of insurance companies and health insuring corporations; (B) The mandated benefit will increase or decrease premiums; (C) Small employers, medium-sized employers, large employers,
and, if applicable, the state and political subdivisions of the state, will be
financially impacted; (D) The mandated benefit will increase or decrease the number of
insured
individuals in this state; and (E) The mandated benefit will impact the total cost and quality
of
health care, including any potential cost savings that may be realized. Sec. 103.147. The chairperson of a standing committee of either house of
the general assembly may, at any time, request the legislative budget officer
to review any bill that is assigned to the chairperson's committee in order to
determine whether the bill includes a mandated benefit. The legislative
budget officer shall review the bill and, if the legislative budget officer
determines that the bill includes a mandated benefit, shall arrange for the
performance of an independent healthcare actuarial review of the mandated
benefit in the same manner as provided in section 103.145 of the
Revised Code. No later than sixty days after receiving the chairperson's request, the
legislative budget officer shall submit the findings of the actuarial review
to
the chairperson and to the ranking minority member of the chairperson's
committee. SECTION 2 . Section 1 of the act shall take effect January 1, 2001.
SECTION 3 . On or before July 15, 2000, the Director of Budget and Management
shall determine and certify to the Legislative Budget Officer the total amount
of unexpended, unobligated appropriations made to the Legislative Budget
Office of the Legislative Service Commission for fiscal year 2000 in
appropriation item 035-403, Legislative Budget Office. Additional
appropriation authority equal to the amount certified is hereby appropriated
to appropriation item 035-403, Legislative Budget Office, for fiscal year
2001.
This section is not subject to the referendum. Therefore, under Ohio
Constitution, Article II, Section 1d and section 1.471 of the Revised Code,
this section goes into immediate effect when this act becomes law.
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