Hawaii Senate bill 1217, which began life as a state-based version of Section 2706 — to ensure that insurers include all types of state-licensed providers in their plans — has passed through state senate committee review and has been re-fashioned to focus on support explicitly for naturopathic physicians (NDs).
The preamble to the bill still retains language taken from Section 2706:
“1. The legislature finds that section 2706 of the federal Public Health Service Act (section 2706), as added by section 1201 of the federal Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), prohibits a group health plan and a health insurance insurer offering group or individual health insurance coverage from discriminating with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable state law.
“The legislature further finds that section 2706 has been understood to prohibit plans from covering a given service when offered by one type of licensed provider while denying coverage when the same service is provided by another type of licensed provider. The legislature additionally finds that discrimination against any provider group, as a whole, is
harmful to patients and restricts their ability to select the provider of their choice.”
The re-focusing of the bill in part stems from the provision in that second paragraph to end discrimination against whole classes of providers, in this case Naturopathic physicians. Because chiropractic and acupuncture already have fairly broad insurance coverage in Hawaii, it was thought necessary to focus SB 1217 on NDs.. Here is how the language states it:
“Requires insurers … to provide coverage for medically necessary health care services covered by a health insurance policy when provided by licensed naturopathic physicians acting within their scope of practice.
“Specifies that health care services provided by naturopathic physicians may be subject to certain limitations.
“Specifies that limitations shall not direct treatment in a manner that unfairly discriminates against the practice of naturopathic medicine.
“Permits insurers to require naturopathic physician services to be provided by a naturopathic physician under contract or covered as consistent with out-of-network provider reimbursement practices.”
The bill will continue to move through the state House committees in the next several weeks.