74th Legislative Session -- 1999
Committee: House Health and Human Services
Friday, January 29, 1999
P - Present
E - Excused
A - Absent
Roll Call
P
Broderick
P
Davis
P
Engbrecht
P
Hanson
P
Hennies
P
McCoy
P
Patterson
P
Peterson
P
Sebert
P
Windhorst
P
Monroe, Vice-Chair
P
Fiegen, Chair
OTHERS PRESENT: See Original Minutes
The meeting was called to order by Representative Fiegen
MOTION:
TO APPROVE THE MINUTES OF PREVIOUS MEETING
Moved by:
Representative Broderick
Second by:
Representative Davis
Action:
Prevailed by voice vote.
HB 1008:
require a managed care plan to contract with any provider willing to meet the
terms and conditions of the plan.
MOTION:
AMEND HB 1008
j-1008e
On page
2
,
after line
7 of the printed bill
,
insert:
"
Section 3. Nothing in this Act applies to dental only, vision only, accident only, school accident, travel,
or specified disease plans or plans that primarily provide a fixed daily, fixed occurrence, or fixed per
procedure benefit without regard to expenses incurred.
"
Moved by:
Representative Engbrecht
Second by:
Representative Broderick
Action:
Prevailed by voice vote.
MOTION:
SUBSTITUTE MOTION DEFER HB 1008 UNTIL THE 41ST LEGISLATIVE DAY
Moved by:
Representative Peterson
Second by:
Representative Sebert
Action:
Failed by roll call vote.
(6-6-0-0)
Voting yes:
Broderick, Hanson, Peterson, Sebert, Windhorst, Fiegen
Voting no:
Davis, Engbrecht, Hennies, McCoy, Patterson, Monroe
MOTION:
AMEND HB 1008
j-1008c
On page
1
,
line
11 of the printed bill
,
after "
plan
"
insert "
. However, unless otherwise stated, the term,
managed care entity, does not include a health care insurer or provider service network offering a
traditional fee-for-service indemnity benefit or a benefit that covers only short-term travel, accident only,
limited benefit, student health plan, or specified disease policies
"
.
Moved by:
Representative Broderick
Second by:
Representative Peterson
Action:
Failed by voice vote.
MOTION:
SUBSTITUTE MOTION AMEND HB 1008
j-1008i
On page
1
,
line
11 of the printed bill
,
after "
plan
"
insert "
. However, unless otherwise stated, the term,
managed care entity, does not include a health care insurer, provider, provider association, or provider
service network offering a traditional fee-for-service indemnity benefit or service or a benefit that covers
only short-term travel, accident only, limited benefit, student health plan, or specified disease policies
"
.
Moved by:
Representative Windhorst
Second by:
None
Action:
Died for a lack of a second
MOTION:
AMEND HB 1008
j-1008g
On page
2 of the printed bill
,
delete lines
5
to
7
, inclusive
.
Moved by:
Representative Sebert
Second by:
Representative Hennies
Action:
Prevailed by voice vote.
MOTION:
DEFER HB 1008 UNTIL Wednesday, February 3, 1999
Moved by:
Representative Broderick
Second by:
Representative McCoy
Action:
Failed by voice vote.
MOTION:
SUBSTITUTE MOTION AMEND HB 1008
j-1008h
On page
2
,
after line
4 of the printed bill
,
insert:
"
Section 2. No managed care plan can deny any licensed health care provider the right to participate
as a provider for the plan on the same terms and conditions as are offered to any other provider under the
plan.
"
Moved by:
Representative Patterson
Second by:
Representative Davis
Action:
Prevailed by roll call vote.
(7-5-0-0)
Voting yes:
Davis, Engbrecht, Hanson, Hennies, McCoy, Patterson, Windhorst
Voting no:
Broderick, Peterson, Sebert, Monroe, Fiegen
MOTION:
DO PASS HB 1008 AS AMENDED
Moved by:
Representative Hennies
Second by:
Representative McCoy
Action:
Failed by roll call vote.
(5-7-0-0)
Voting yes:
Davis, Engbrecht, Hennies, McCoy, Patterson
Voting no:
Broderick, Hanson, Peterson, Sebert, Windhorst, Monroe, Fiegen
MOTION:
TO TABLE HB 1008
Moved by:
Representative Broderick
Second by:
Representative Monroe
Action:
Failed by roll call vote.
(6-6-0-0)
Voting yes:
Broderick, Peterson, Sebert, Windhorst, Monroe, Fiegen
Voting no:
Davis, Engbrecht, Hanson, Hennies, McCoy, Patterson
MOTION:
WITHOUT RECOMMENDATION
Moved by:
Representative Patterson
Second by:
Representative Davis
Action:
The Chair deferred HB 1008 with the pending motion until Wednesday, February 3, 1999.
HB 1009:
require a managed care plan to have a medical director or clinical peer
director.
MOTION:
AMEND HB 1009
j-1009e
On page
2
,
after line
7 of the printed bill
,
insert:
"
Section 3. Nothing in this Act applies to dental only, vision only, accident only, school accident, travel,
or specified disease plans or plans that primarily provide a fixed daily, fixed occurrence, or fixed per
procedure benefit without regard to expenses incurred.
"
Moved by:
Representative Peterson
Second by:
Representative Davis
Action:
Prevailed by voice vote.
MOTION:
AMEND HB 1009
j-1009f
On page
1
,
line
11 of the printed bill
,
after "
plan
"
insert "
. However, unless otherwise stated, the term,
managed care entity, does not include a health care insurer, provider, provider association, or provider
service network offering a traditional fee-for-service indemnity benefit or a benefit that covers only short-
term travel, accident only, limited benefit, student health plan, or specified disease policies
"
.
Moved by:
Representative Windhorst
Second by:
Representative Patterson
Action:
Failed by roll call vote.
(3-9-0-0)
Voting yes:
Patterson, Windhorst, Monroe
Voting no:
Broderick, Davis, Engbrecht, Hanson, Hennies, McCoy, Peterson, Sebert, Fiegen
MOTION:
AMEND THE AMENDMENT
j-1009g
After "indemnity benefit" insert "or service".
Moved by:
Representative Windhorst
Second by:
Representative Patterson
Action:
Prevailed by voice vote.
MOTION:
AMEND HB 1009
j-1009
On page
2
,
line
4 of the printed bill
,
delete "
under chapter 36-4
"
.
On page
2
,
line
5
,
delete "
clinical peer
"
and insert "
director
"
.
On page
2
,
line
6
,
delete "
this state, as director
"
and insert "
that healing art
"
.
Moved by:
Representative Broderick
Second by:
Representative Peterson
Action:
Prevailed by voice vote.
MOTION:
AMEND THE AMENDMENT
j-1009h
On line 1 of the pending amendment, before the "." insert "and insert "practice medicine in at least one
state in the United States"".
Moved by:
Representative Patterson
Second by:
Action:
Withdrawn.
MOTION:
AMEND HB 1009
j-1009c
On page
1
,
line
11 of the printed bill
,
after "
plan
"
insert "
. However, unless otherwise stated, the term,
managed care entity, does not include a health care insurer or provider service network offering a
traditional fee-for-service indemnity benefit or a benefit that covers only short-term travel, accident only,
limited benefit, student health plan, or specified disease policies
"
.
Moved by:
Representative Monroe
Second by:
Representative Windhorst
Action:
Failed by roll call vote.
(2-10-0-0)
Voting yes:
Windhorst, Monroe
Voting no:
Broderick, Davis, Engbrecht, Hanson, Hennies, McCoy, Patterson, Peterson, Sebert,
Fiegen
MOTION:
DO PASS HB 1009 AS AMENDED
Moved by:
Representative Peterson
Second by:
Representative McCoy
Action:
Prevailed by roll call vote.
(12-0-0-0)
Voting yes:
Broderick, Davis, Engbrecht, Hanson, Hennies, McCoy, Patterson, Peterson, Sebert,
Windhorst, Monroe, Fiegen
MOTION:
TO AMEND TITLE OF HB 1009
j-1009T
On page
1
,
line
2 of the printed bill
,
delete "
clinical peer
"
.
Moved by:
Representative Peterson
Second by:
Representative Engbrecht
Action:
Prevailed by voice vote.
HB 1010:
provide certain protections for persons enrolled in managed care plans.
MOTION:
AMEND HB 1010
j-1010e
On page
5
,
after line
12 of the printed bill
,
insert:
"
Section 9. Nothing in this Act applies to dental only, vision only, accident only, school accident, travel,
or specified disease plans or plans that primarily provide a fixed daily, fixed occurrence, or fixed per
procedure benefit without regard to expenses incurred. The provisions of this Act only apply to oral or
written communications specifically designed to elicit an application for insurance.
"
Moved by:
Representative Peterson
Second by:
Representative Sebert
Action:
Prevailed by voice vote.
MOTION:
AMEND HB 1010
j-1010
On page
3
,
line
14 of the printed bill
,
after "
for
"
insert "
covered
"
.
On page
3
,
line
22
,
delete "
, to be
"
.
On page
3
,
line
23
,
delete "
devised by the division
"
.
On page
4
,
delete lines
9
to
11
, inclusive
.
On page
4
,
line
12
,
delete "
(6)
"
and insert "
(5)
"
.
On page
4
,
line
20
,
delete "
(7)
"
and insert "
(6)
"
.
On page
5
,
line
1
,
delete "
(8)
"
and insert "
(7)
"
.
Moved by:
Representative Broderick
Second by:
Representative Monroe
Action:
Prevailed by voice vote.
MOTION:
AMEND HB 1010
j-1010f
On page
5
,
after line
12 of the printed bill
,
insert:
"
Section 9. If the director of the Division of Insurance and the secretary of the Department of Health
find that the requirements of any private accrediting body meet the requirements of this Act, the managed
care plan may, at the discretion of the director and secretary, be deemed to have met the applicable
requirements.
"
Moved by:
Representative Hanson
Second by:
Representative Hennies
Action:
Prevailed by voice vote.
MOTION:
AMEND HB 1010
j-1010c
On page
1
,
line
13 of the printed bill
,
after "
plan
"
insert "
. However, unless otherwise stated, the term,
managed care entity, does not include a health care insurer or provider service network offering a
traditional fee-for-service indemnity benefit or a benefit that covers only short-term travel, accident only,
limited benefit, student health plan, or specified disease policies
"
.
Moved by:
Representative Monroe
Second by:
Representative Engbrecht
Action:
Failed by voice vote.
MOTION:
DO PASS HB 1010 AS AMENDED
Moved by:
Representative Davis
Second by:
Representative McCoy
Action:
Prevailed by roll call vote.
(11-1-0-0)
Voting yes:
Broderick, Davis, Engbrecht, Hanson, Hennies, McCoy, Patterson, Peterson, Sebert,
Windhorst, Fiegen
Voting no:
Monroe
HB 1011:
provide covered persons in managed care plans with reasonable access to
providers.
MOTION:
AMEND HB 1011
j-1011e
On page
2
,
after line
19 of the printed bill
,
insert:
"
Section 3. Nothing in this Act applies to dental only, vision only, accident only, school accident, travel,
or specified disease plans or plans that primarily provide a fixed daily, fixed occurrence, or fixed per
procedure benefit without regard to expenses incurred.
"
Moved by:
Representative Peterson
Second by:
Representative Hanson
Action:
Prevailed by voice vote.
MOTION:
AMEND HB 1011
j-1011b
On page
2
,
after line
19 of the printed bill
,
insert:
"
Section 3. If the director of the Division of Insurance and the secretary of the Department of Health
find that the requirements of any private accrediting body meet the requirements of network adequacy as
set forth in this Act, the managed care plan may, at the discretion of the director and secretary, be deemed
to have met the applicable requirements.
"
Moved by:
Representative Broderick
Second by:
Representative Sebert
Action:
Prevailed by voice vote.
MOTION:
AMEND HB 1011
j-1011c
On page
1
,
line
11 of the printed bill
,
after "
plan
"
insert "
. However, unless otherwise stated, the term,
managed care entity, does not include a health care insurer or provider service network offering a
traditional fee-for-service indemnity benefit or a benefit that covers only short-term travel, accident only,
limited benefit, student health plan, or specified disease policies
"
.
Moved by:
Representative Monroe
Second by:
Representative Sebert
Action:
Failed by roll call vote.
(5-7-0-0)
Voting yes:
Broderick, Engbrecht, Patterson, Windhorst, Monroe
Voting no:
Davis, Hanson, Hennies, McCoy, Peterson, Sebert, Fiegen
MOTION:
AMEND HB 1011
j-1011a
On page
2
,
after line
19 of the printed bill
,
insert:
"
Section 3. A managed care plan shall offer a point of service option allowing a covered person to
choose to receive service from a nonparticipating health care provider. The point of service option may
require that the covered person pay a reasonable portion of the costs not to exceed twenty percent.
Section 4. If an employer provides a managed care plan to eligible employees and the plan restricts
access to providers and does not provide a point of service or out-of-network benefit, the employer shall
offer at the time of enrollment and annually thereafter, an alternative health benefit plan that is either a non-
network plan or a network plan that provides out-of-network services. Unless the employer chooses to
provide any extra contribution to the premium, any extra cost associated with the alternative health benefit
plan required by this section shall be borne by the employee choosing that coverage and at no additional
cost to the employer.
"
Moved by:
Representative Davis
Second by:
Representative McCoy
Action:
Failed by roll call vote.
(5-7-0-0)
Voting yes:
Davis, McCoy, Patterson, Windhorst, Monroe
Voting no:
Broderick, Engbrecht, Hanson, Hennies, Peterson, Sebert, Fiegen
MOTION:
DO PASS HB 1011 AS AMENDED
Moved by:
Representative Broderick
Second by:
Representative Hennies
Action:
Prevailed by roll call vote.
(11-1-0-0)
Voting yes:
Broderick, Davis, Engbrecht, Hanson, Hennies, McCoy, Patterson, Peterson, Sebert,
Windhorst, Fiegen
Voting no:
Monroe
HB 1012:
provide utilization review of managed care plans.
MOTION:
AMEND HB 1012
j-1012e
On page
12
,
after line
24 of the printed bill
,
insert:
"
Section 41. Nothing in this Act applies to dental only, vision only, accident only, school accident,
travel, or specified disease plans or plans that primarily provide a fixed daily, fixed occurrence, or fixed
per procedure benefit without regard to expenses incurred.
"
Moved by:
Representative Hennies
Second by:
Representative Davis
Action:
Prevailed by voice vote.
MOTION:
AMEND HB 1012
j-1012f
On page
2
,
line
4 of the printed bill
,
delete "
in the state of South Dakota and
"
.
On page
2
,
line
14
,
delete everything after "
plan
"
.
On page
2
,
line
15
,
delete "
person
"
.
On page
6
,
line
7
,
after "
Qualified
"
insert "
licensed
"
.
On page
6
,
line
7
,
delete "
, licensed and in active practice,
"
.
On page
10
,
delete lines
22
to
25
, inclusive
.
On page
11
,
delete lines
1
to
25
, inclusive
.
On page
12
,
delete lines
1
to
12
, inclusive
.
On page
12
,
delete lines
23
and
24
.
Moved by:
Representative Hennies
Second by:
Representative McCoy
Action:
Prevailed by voice vote.
MOTION:
AMEND HB 1012
j-1012b
On page
12
,
after line
24 of the printed bill
,
insert:
"
Section 41. If the director of the Division of Insurance and the secretary of the Department of Health
find that the requirements of any private accrediting body meet the requirements of utilization review as
set forth in this Act, the managed care plan may, at the discretion of the director and secretary, be deemed
to have met the applicable requirements.
"
Moved by:
Representative Peterson
Second by:
Representative Sebert
Action:
Prevailed by voice vote.
MOTION:
AMEND HB 1012
j-1012c
On page
3
,
line
13 of the printed bill
,
after "
plan
"
insert "
. However, unless otherwise stated, the term,
managed care entity, does not include a health care insurer or provider service network offering a
traditional fee-for-service indemnity benefit or a benefit that covers only short-term travel, accident only,
limited benefit, student health plan, or specified disease policies
"
.
Moved by:
Representative Monroe
Second by:
None
Action:
Died for a lack of a second
MOTION:
AMEND HB 1012
j-1012a
On page
6
,
line
4 of the printed bill
,
after "
vendors.
"
insert "
However, any clinical review criteria shall
include any guidelines or parameters adopted by the respective professional board of examiners or set forth
in state law or rule.
"
.
Moved by:
Representative Davis
Second by:
Representative Monroe
Action:
Failed by roll call vote.
(5-7-0-0)
Voting yes:
Davis, Engbrecht, McCoy, Patterson, Monroe
Voting no:
Broderick, Hanson, Hennies, Peterson, Sebert, Windhorst, Fiegen
MOTION:
DO PASS HB 1012 AS AMENDED
Moved by:
Representative Peterson
Second by:
Representative Patterson
Action:
Prevailed by roll call vote.
(11-1-0-0)
Voting yes:
Broderick,Davis, Engbrecht, Fiegen, Hanson, Hennies, McCoy, Patterson,Peterson,
Sebert, Windhorst
Voting no:
Monroe
HB 1013:
establish certain requirements regarding coverage of emergency medical
services in managed care plans.
MOTION:
AMEND HB 1013
j-1013e
On page
3
,
after line
20 of the printed bill
,
insert:
"
Section 7. Nothing in this Act applies to dental only, vision only, accident only, school accident, travel,
or specified disease plans or plans that primarily provide a fixed daily, fixed occurrence, or fixed per
procedure benefit without regard to expenses incurred.
"
Moved by:
Representative Peterson
Second by:
Representative Hennies
Action:
Prevailed by voice vote.
MOTION:
AMEND HB 1013
j-1013b
On page
3
,
after line
20 of the printed bill
,
insert:
"
Section 7. If the director of the Division of Insurance and the secretary of the Department of Health
find that the requirements of any private accrediting body meet the requirements of coverage of emergency
medical services as set forth in this Act, the managed care plan may, at the discretion of the director and
secretary, be deemed to have met the applicable requirements.
"
Moved by:
Representative Davis
Second by:
Representative Patterson
Action:
Prevailed by voice vote.
MOTION:
AMEND HB 1013
j-1013a
On page
3
,
line
9 of the printed bill
,
delete "
an item or service
"
and insert "
a covered expense
"
.
Moved by:
Representative Hennies
Second by:
Representative Patterson
Action:
Prevailed by voice vote.
MOTION:
DO PASS HB 1013 AS AMENDED
Moved by:
Representative Hennies
Second by:
Representative McCoy
Action:
Prevailed by roll call vote.
(12-0-0-0)
Voting yes:
Broderick, Davis, Engbrecht, Hanson, Hennies, McCoy, Patterson, Peterson, Sebert,
Windhorst, Monroe, Fiegen
MOTION:
ADJOURN
Moved by:
Representative Broderick
Second by:
Representative Davis
Action:
Prevailed by voice vote.
Doris J. Donner
_________________________________
Committee Secretary
Kristie K. Fiegen, Chair
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