77th Legislative Session _ 2002

Committee: Senate Health and Human Services
Wednesday, February 06, 2002

                                            P - Present
                                            E - Excused
                                            A - Absent

Roll Call
P    Diedtrich (Elmer)
P    Ham
P    McIntyre
P    Staggers
P    Sutton (Dan)
P    Olson (Ed), Vice-Chair
E    Albers, Chair

OTHERS PRESENT: See Original Minutes

The meeting was called to order by Senator Ed Olson, Vice-Chair.

MOTION:     TO APPROVE THE MINUTES OF FEBRUARY 4, 2002.

Moved by:    McIntyre
Second by:    Staggers
Action:    Prevailed by voice vote.

MOTION:     RECONSIDER SB 117

Moved by:    Ham
Second by:    Sutton (Dan)
Action:    Prevailed by roll call vote.(6-0-1-0)

Voting Yes:    Diedtrich (Elmer), Ham, McIntyre, Staggers, Sutton (Dan), Olson (Ed)

Excused:    Albers

         SB 117: provide that donations of body parts evidenced by driver's licenses and nondriver identification cards not be used for research and education.

Presented By:    Senator Reedy, Dist. 17.


Proponents:    None
Opponents:    Dean Krogman, Sioux Falls, SD State Medical Assn.

MOTION:     AMEND SB 117

117ja
     Delete the previous amendment (117ta).

     On the printed bill, delete everything after the enacting clause and insert:

"      Section 1. That § 58-17C-1 be amended by adding thereto NEW SUBDIVISIONS to read as follows:

     "Point of service option," an option for the covered person to choose to receive service from a nonparticipating health care professional or provider;

     "Primary care practitioner," a health care professional under contract with the managed care plan, who has been designated by the plan to coordinate, supervise, or provide ongoing care to the covered person;

     "Specialist," a health care professional who falls outside the definition of a primary care practitioner.

     Section 2. That § 58-17C-8 be amended to read as follows:

     58-17C-8.   A health carrier providing a managed care plan shall maintain a network that is sufficient in numbers and types of providers to assure that all services to covered persons will be accessible without unreasonable delay. Each managed care plan shall permit covered persons to choose their own primary care practitioner from a list of health care professionals within the plan. In the case of emergency services, covered persons shall have access twenty-four hours per day, seven days per week. Sufficiency shall be determined in accordance with the requirements of this section, and may be established by reference to any reasonable criteria used by the carrier, including: provider-covered person ratios by specialty; primary care provider-covered person ratios; geographic accessibility; waiting times for appointments with participating providers; hours of operation; and the volume of technological and specialty services available to serve the needs of covered persons requiring technologically advanced or specialty care.

     Section 3. That chapter 58-17C be amended by adding thereto a NEW SECTION to read as follows:

     Each managed care plan shall develop a system to permit covered persons to use a medical specialist primary care practitioner, if the covered person's medical condition warrants it. This may include covered persons suffering from chronic diseases as well as those with other special needs.

     Section 4. That chapter 58-17C be amended by adding thereto a NEW SECTION to read as follows:

     Each managed care plan shall offer a point-of-service option. The point-of-service option may require that the covered person in the plan pay a reasonable portion of the costs not to exceed twenty percent of such out-of-plan care.

     Section 5. That chapter 58-17C be amended by adding thereto a NEW SECTION to read as follows:

     Each managed care entity has the duty to exercise ordinary care when making health care treatment decisions and is liable for damages to a covered person for harm proximately caused by its failure to exercise ordinary care."

Moved by:    McIntyre
Second by:    Sutton (Dan)
Action:    Prevailed by voice vote.

MOTION:     DEFER SB 117 TO THE 36TH LEGISLATIVE DAY

Moved by:    Ham
Second by:    Diedtrich (Elmer)
Action:    Prevailed by roll call vote.(4-2-1-0)

Voting Yes:    Diedtrich (Elmer), Ham, McIntyre, Olson (Ed)

Voting No:    Staggers, Sutton (Dan)

Excused:    Albers

MOTION:     ADJOURN

Moved by:    Sutton (Dan)
Second by:    Diedtrich (Elmer)
Action:    Prevailed by voice vote.

Beverly Jennings

____________________________

Committee Secretary
Ed Olson, Vice-Chair


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