Health insurance coverage; requiring health benefit plans to provide coverage for at home care for persons with certain conditions; specifying terms of coverage. Effective date.
Impact
This bill is positioned to significantly impact the accessibility of health insurance for families dealing with developmental disabilities by ensuring that necessary home care services are covered. For insurers, compliance will necessitate adjustments in policy offerings, including establishing terms that align with the new coverage requirements. As such, starting January 1, 2024, any health benefit plans issued or renewed will need to include this coverage, affecting not only private insurers but also the Oklahoma Employees Insurance Plan.
Summary
Senate Bill 769, introduced by Senator Hicks, mandates that health benefit plans in Oklahoma provide coverage for home health care services for individuals with developmental disabilities. The bill clearly defines a developmental disability as any severe, chronic disability that manifests before the age of twenty-two and is likely to continue indefinitely. This legislation stipulates that coverage must be offered for home health care that necessitates supervision by licensed health professionals, thereby expanding care options for affected individuals.
Contention
Some points of contention surrounding SB769 may relate to its potential financial implications for insurers and how these changes could impact premium costs or the scope of coverage provided. Stakeholders may debate the adequacy of reimbursement rates for home health care professionals under these plans. Additionally, discussions may arise regarding the definitions set forth in the bill, specifically what constitutes a developmental disability and how this might affect eligibility for coverage.
Carry Over
Health insurance coverage; requiring health benefit plans to provide coverage for at home care for persons with certain conditions; specifying terms of coverage. Effective date.
Health insurance coverage; requiring health benefit plans to provide coverage for at home care for persons with certain conditions; specifying terms of coverage. Effective date.
Public health and safety; step therapy requirements for certain drugs for certain conditions; definitions; authorizing a health benefit plan to allow coverage for prescription drugs for advanced metastatic cancer and associated conditions without proving step therapy; effective date.
Health insurance; prohibiting insurers from refusing coverage under certain circumstances; requiring out-of-network providers be reimbursed at the same rate as in-network providers. Emergency.
Medicaid; requiring coverage of medically necessary donor human milk-derived products under certain conditions; requiring certain reimbursement. Effective date. Emergency.
Public health and safety; state Medicaid program; not to contract with out of state providers; unauthorizing the Health Care Authority from providing certain coverage; effective date.