STATE LEGISLATIVE PACKET (3) BOB WEISS
=========================
VIRGINIA
HOUSE BILL NO. 1737
Offered January 8, 2003
Prefiled January 6, 2003
A BILL to amend and reenact § 38.2-4319, as it is currently effective
and as it
shall become effective, of the Code of Virginia and to amend the Code
of
Virginia by adding a section numbered 38.2-3418.14, relating to health
insurance
coverage for lymphedema.
----------
Patron-- Wardrup
----------
Referred to Committee on Commerce and Labor
----------
Be it enacted by the General Assembly of Virginia:
1. That § 38.2-4319 of the Code of Virginia, as it is currently
effective and
as it shall become effective, is amended and reenacted, and that the
Code of
Virginia is amended by adding a section numbered 38.2-3418.14 as
follows:
§ 38.2-3418.14. Coverage for lymphedema.
A. Notwithstanding the provisions of § 38.2-3419, each insurer
proposing to
issue individual or group accident and sickness insurance policies
providing
hospital, medical and surgical, or major medical, coverage on an
expense-incurred basis; each corporation providing individual or group
accident
and sickness subscription contracts; and each health maintenance
organization
providing a health care plan for health care services shall provide
coverage for
lymphedema as provided in this section.
B. Coverage under this section shall include benefits for equipment,
supplies,
complex decongestive therapy, and outpatient self-management training
and
education for the treatment of lymphedema, if prescribed by a health
care
professional legally authorized to prescribe or provide such items
under law.
C. A managed care health insurance plan, as defined in Chapter 58 (§
38.2-5800
et seq.) of this title, may require such health care professional to be
a member
of the plan's provider network, provided that such network includes
sufficient
health care professionals who are qualified by specific education,
experience,
and credentials to provide the covered benefits described in this
section.
D. No insurer, corporation, or health maintenance organization shall
impose upon
any person receiving benefits pursuant to this section any copayment,
fee,
policy year or calendar year, or durational benefit limitation or
maximum for
benefits or services that is not equally imposed upon all individuals
in the
same benefit category.
E. The requirements of this section shall apply to all insurance
policies,
contracts and plans delivered, issued for delivery, reissued, or
extended on and
after January 1, 2004, or at any time thereafter when any term of the
policy,
contract or plan is changed or any premium adjustment is made.
F. This section shall not apply to short-term travel, accident only,
limited or
specified disease, or individual conversion policies or contracts, nor
to
policies or contracts designed for issuance to persons eligible for
coverage
under Title XVIII of the Social Security Act, known as Medicare, or any
other
similar coverage under state or federal governmental plans.
§ 38.2-4319. (Effective until July 1, 2004) Statutory construction and
relationship to other laws.
A. No provisions of this title except this chapter and, insofar as they
are not
inconsistent with this chapter, §§ 38.2-100, 38.2-200, 38.2-203,
38.2-209
through 38.2-213, 38.2-218 through 38.2-225, 38.2-229, 38.2-232,
38.2-305,
38.2-316, 38.2-322, 38.2-400, 38.2-402 through 38.2-413, 38.2-500
through
38.2-515, 38.2-600 through 38.2-620, Chapter 9 (§ 38.2-900 et seq.), §§
38.2-1017 through 38.2-1023, 38.2-1057, Articles 2 (§ 38.2-1306 et
seq.), 4 (§
38.2-1317 et seq.) and 5 (§ 38.2-1322 et seq.) of Chapter 13, Articles
1 (§
38.2-1400 et seq.) and 2 (§ 38.2-1412 et seq.) of Chapter 14, §§
38.2-1800
through 38.2-1836, 38.2-3401, 38.2-3405, 38.2-3405.1, 38.2-3407.2
through
38.2-3407.6:1, 38.2-3407.9 through 38.2-3407.16, 38.2-3411.2,
38.2-3411.3,
38.2-3411.4, 38.2-3412.1:01, 38.2-3414.1, 38.2-3418.1 through
38.2-3418.12,
38.2-3418.14, 38.2-3419.1, 38.2-3430.1 through 38.2-3437, 38.2-3500,
subdivision
13 of § 38.2-3503, subdivision 8 of § 38.2-3504, §§ 38.2-3514.1,
38.2-3514.2, 38.2-3522.1 through 38.2-3523.4, 38.2-3525, 38.2-3542,
38.2-3543.2,
Chapter 52 (§ 38.2-5200 et seq.), Chapter 55 (§ 38.2-5500 et seq.),
Chapter 58
(§ 38.2-5800 et seq.), and § 38.2-5903 of this title shall be
applicable to
any health maintenance organization granted a license under this
chapter. This
chapter shall not apply to an insurer or health services plan licensed
and
regulated in conformance with the insurance laws or Chapter 42 (§
38.2-4200 et
seq.) of this title except with respect to the activities of its health
maintenance organization.
B. Solicitation of enrollees by a licensed health maintenance
organization or by
its representatives shall not be construed to violate any provisions of
law
relating to solicitation or advertising by health professionals.
C. A licensed health maintenance organization shall not be deemed to be
engaged
in the unlawful practice of medicine. All health care providers
associated with
a health maintenance organization shall be subject to all provisions of
law.
D. Notwithstanding the definition of an eligible employee as set forth
in §
38.2-3431, a health maintenance organization providing health care
plans
pursuant to § 38.2-3431 shall not be required to offer coverage to or
accept
applications from an employee who does not reside within the health
maintenance
organization's service area.
E. For purposes of applying this section, "insurer" when used in a
section cited in subsection A of this section shall be construed to
mean and
include "health maintenance organizations" unless the section cited
clearly applies to health maintenance organizations without such
construction.
§ 38.2-4319. (Effective July 1, 2004) Statutory construction and
relationship
to other laws.
A. No provisions of this title except this chapter and, insofar as they
are not
inconsistent with this chapter, §§ 38.2-100, 38.2-200, 38.2-203,
38.2-209
through 38.2-213, 38.2-218 through 38.2-225, 38.2-229, 38.2-232,
38.2-305,
38.2-316, 38.2-322, 38.2-400, 38.2-402 through 38.2-413, 38.2-500
through
38.2-515, 38.2-600 through 38.2-620, Chapter 9 (§ 38.2-900 et seq.), §§
38.2-1017 through 38.2-1023, 38.2-1057, Articles 2 (§ 38.2-1306 et
seq.), 4 (§
38.2-1317 et seq.) and 5 (§ 38.2-1322 et seq.) of Chapter 13, Articles
1 (§
38.2-1400 et seq.) and 2 (§ 38.2-1412 et seq.) of Chapter 14, §§
38.2-1800
through 38.2-1836, 38.2-3401, 38.2-3405, 38.2-3405.1, 38.2-3407.2
through
38.2-3407.6:1, 38.2-3407.9 through 38.2-3407.16, 38.2-3411.2,
38.2-3411.3,
38.2-3411.4, 38.2-3414.1, 38.2-3418.1 through 38.2-3418.12,
38.2-3418.14,
38.2-3419.1, 38.2-3430.1 through 38.2-3437, 38.2-3500, subdivision 13
of §
38.2-3503, subdivision 8 of § 38.2-3504, §§ 38.2-3514.1, 38.2-3514.2,
38.2-3522.1 through 38.2-3523.4, 38.2-3525, 38.2-3542, 38.2-3543.2,
Chapter 52 (§
38.2-5200 et seq.), Chapter 55 (§ 38.2-5500 et seq.), Chapter 58 (§
38.2-5800
et seq.) and § 38.2-5903 of this title shall be applicable to any
health
maintenance organization granted a license under this chapter. This
chapter
shall not apply to an insurer or health services plan licensed and
regulated in
conformance with the insurance laws or Chapter 42 (§ 38.2-4200 et seq.)
of this
title except with respect to the activities of its health maintenance
organization.
B. Solicitation of enrollees by a licensed health maintenance
organization or by
its representatives shall not be construed to violate any provisions of
law
relating to solicitation or advertising by health professionals.
C. A licensed health maintenance organization shall not be deemed to be
engaged
in the unlawful practice of medicine. All health care providers
associated with
a health maintenance organization shall be subject to all provisions of
law.
D. Notwithstanding the definition of an eligible employee as set forth
in §
38.2-3431, a health maintenance organization providing health care
plans
pursuant to § 38.2-3431 shall not be required to offer coverage to or
accept
applications from an employee who does not reside within the health
maintenance
organization's service area.
E. For purposes of applying this section, "insurer" when used in a
section cited in subsection A of this section shall be construed to
mean and
include "health maintenance organizations" unless the section cited
clearly applies to health maintenance organizations without such
construction.
================================================
Join us as we work for lymphedema patients everywehere:
Advocates for Lymphedema
Dedicated to be an advocacy group for lymphedema patients. Working towards education, legal reform, changing insurance practices, promoting research, reaching for a cure.
http://health.groups.yahoo.com/group/AdvocatesforLymphedema/
Subscribe: | AdvocatesforLymphedema-subscribe@yahoogroups.com |
Pat O'Connor
Lymphedema People / Advocates for Lymphedema
================================================
Lymphedema People New Wiki Pages
Have
you seen our new
“Wiki” pages yet? Listed
below
are just a sample of the more than 140 pages now listed in our Wiki
section. We
are also working on hundred more.
Come
and take a stroll!
Lymphedema
Glossary
http://www.lymphedemapeople.com/wiki/doku.php?id=glossary:listing
Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema
Arm
Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=arm_lymphedema
Leg
Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=leg_lymphedema
Acute
Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=acute_lymphedema
The
Lymphedema Diet
http://www.lymphedemapeople.com/wiki/doku.php?id=the_lymphedema_diet
Exercises
for Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=exercises_for_lymphedema
Diuretics
are not for
Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=diuretics_are_not_for_lymphedema
Lymphedema
People Online
Support Groups
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_people_online_support_groups
Lipedema
http://www.lymphedemapeople.com/wiki/doku.php?id=lipedema
Treatment
http://www.lymphedemapeople.com/wiki/doku.php?id=treatment
Lymphedema
and Pain
Management
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_and_pain_management
Manual
Lymphatic Drainage (MLD) and Complex Decongestive Therapy (CDT)
Infections
Associated with
Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=infections_associated_with_lymphedema
How
to Treat a Lymphedema
Wound
http://www.lymphedemapeople.com/wiki/doku.php?id=how_to_treat_a_lymphedema_wound
Fungal
Infections Associated
with Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=fungal_infections_associated_with_lymphedema
Lymphedema
in Children
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_in_children
Lymphoscintigraphy
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphoscintigraphy
Magnetic
Resonance Imaging
http://www.lymphedemapeople.com/wiki/doku.php?id=magnetic_resonance_imaging
Extraperitoneal
para-aortic lymph node dissection (EPLND)
Axillary
node biopsy
http://www.lymphedemapeople.com/wiki/doku.php?id=axillary_node_biopsy
Sentinel
Node Biopsy
http://www.lymphedemapeople.com/wiki/doku.php?id=sentinel_node_biopsy
Small
Needle Biopsy - Fine Needle Aspiration
http://www.lymphedemapeople.com/wiki/doku.php?id=small_needle_biopsy
Magnetic
Resonance Imaging
http://www.lymphedemapeople.com/wiki/doku.php?id=magnetic_resonance_imaging
Lymphedema
Gene FOXC2
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_foxc2
Lymphedema Gene VEGFC
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_vegfc
Lymphedema Gene SOX18
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_sox18
Lymphedema
and
Pregnancy
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_and_pregnancy
Home page: Lymphedema People
http://www.lymphedemapeople.com
Page Updated: May 8, 2008