CHIP-state administration.

2018
STATE OF WYOMING
18LSO-0373
Numbered
1.2

HOUSE BILL

NO.
HB0081

CHIP-state administration.

Sponsored by:
Representative(s) Larsen and Wilson and Senator(s) Driskill

A BILL

for

AN ACT relating to the child health insurance program; authorizing the program to be provided by the state or by a private insurance company; amending charge and collection limits; discontinuing the CHIP health benefits plan committee; making conforming amendments; and providing for an effective date.

Be It Enacted by the Legislature of the State of Wyoming:

Section 1
.

W.S.
35
‑
25
‑
103,

35
‑
25
‑
106
(a) and (b
)
and 35
‑
25
‑
108(b)
(
i
)
are amended to read:

35
‑
25
‑
103
.

Child health insurance program eligibility
; services by department or private health insurance
.

(a)

Subject to approval of the state plan by the United States secretary of health and human services, and subject to available state and federal funding the department shall provide a health insurance plan
offered through a private insurance company licensed by the insurance commissioner to write insurance in Wyoming
for an eligible child whose monthly gross family income is not more than one hundred eighty
‑
five percent (185%) of the federal poverty level, until July 1, 2005, and thereafter, whose monthly gross family income is not more than two hundred percent (200%) of the federal poverty level.

A child who is determined eligible to receive benefits under this section shall remain eligible for twelve (12) months as long as the child resides in the state of Wyoming and has not yet attained nineteen (19) years of age. A child
'
s eligibility to receive benefits under this act shall be
redetermined
on an annual basis. A simplified application process, which includes minimum eligibility requirements, shall be provided throughout the state at various public and private establishments approved by the department of health. To be determined eligible to receive benefits under this section, a child shall not be eligible under the
Wyoming Medical Assistance and Services Act, shall not have been covered under another health insurance plan for a minimum of one (1) month prior to application for coverage under this act or, upon birth, the child would not otherwise be covered by a public or private health insurance plan. Eligibility under this section shall be determined by the departm
ent of health or its designee.

(b)

The
child
health insurance plan
required by subsection (a) of this section
shall
be
provided
either

through a private
health
insurance company licensed by the insurance commissioner to write insurance in Wyoming or by
the department of health
'
s
division responsible for administering the Medicaid program
. The department
'
s
division
shall be used
to provide the insurance plan
only if it can provide the plan
at a lower cost
than
can a
qualified private insurance company
or
if use of the division
will otherwise accrue more benefits to the state than will use of a private insurance company.

(c)

A medical provider who accepts payment for
services provided under this section
shall not charge or attempt to c
ollect payments in excess of a
rate schedule
established by the department
or in exc
ess of rates negotiated with a
private health insurance company
who is
offering child health insurance
pursuant to
this act
.

35
‑
25
‑
106
.

Private health insurance plan request for proposals.

(a)

If
the
child
health insurance plan
required by W.S. 35
‑
25
‑
103
will be provided
through a private health insurance company, t
he department shall
publish notice o
f
issue
a request for proposals from qualified insurers
to provide a health insurance plan for children insured under W.S. 35
‑
25
‑
103 of this act. The departmen
t
and
shall award the contract for this service to an insurer based on price, the provision of
benchmar
k
required
services
determined pursuant to W.S. 35
‑
25
‑
105(c)
,
and other factors listed in the department
'
s request

for proposals
.
Th
e
A
contract for health insurance awarded under this section shall contain provisions with respect to exclusions from coverage for preexisting conditions that are no more restrictive than those described in 42 U.S.C. 1397bb(b)(1)(B)(ii). The contract shall include provisions for changes in terms and conditions and for rebidding in case major changes are
needed. The department shall have the right to rebid the contract after two (2) years.

(b)

Biennially, the department may allow
th
e
a
contractor

providing
child
health insurance pursuant to subsection (a) of this section
to adjust the price charged for the coverage, but if the price is increased, the department may, after public notice, rebid the contract.

35
‑
25
‑
108
.

Implementation; duties; restrictions on the department of health.

(b)

The department shall not implement:

(
i
)

The program under this act until a state plan has been approved by the United States secretary of health and human services

or, for any modified plan
, until the modified p
lan
has been approved if the modifications require the approval of the United States secretary of health and human services
; and

Section 2
.

W.S. 35
‑
25
‑
104(a)(intro) as amended by 2017 Wyoming Session Laws, Chapter 60, Section 1 is amended read:

35
‑
25
‑
104
.

Program benefits.

(a)

A child eligible for services under this act shall receive benefits developed by the
health benefits committee established under W.S. 35
‑
25
‑
105
department as allowed by 42 U.S.C. 1397cc et seq. and
that include:

Section 3
.

W.S.
35
‑
25
‑
105 and
35
‑
25
‑
106(c) are repealed.

Section 4
.

This act is effective
March 31, 2018
.

(END)

1
HB0081