HD24 - House Bill 1233 Mandated Coverage for Prescription Contraceptive Drugs


Executive Summary:
The House Committee on Corporations, Insurance and Banking referred House Bill 1233 to the Special Advisory Commission on Mandated Health Insurance Benefits (Advisory Commission) during the 1996 Session of the General Assembly. House Bill 1233 is patroned by Delegate Julia Connally.

The Advisory Commission held a public hearing on August 20, 1996 in Richmond to receive comments. Six speakers addressed the proposal. In addition to the patron, a representative from the Virginia Affiliate of the National Abortion and Reproductive Rights Action League (VA NARAL) and a representative from Planned Parenthood Advocates of Virginia (Planned Parenthood) spoke in favor of the bill. Written testimony in favor of the bill was received from representatives from VA NARAL, Planned Parenthood, the American Jewish Congress, the Virginia Federation of Business and Professional Women's Club, Inc., Zero Population Growth (ZPG), and fifteen concerned citizens. Representatives from the Health Insurance Association of America (HIAA), Trigon Blue Cross Blue Shield (Trigon), and the Virginia Association of Health Maintenance Organizations (VAHMO) spoke in opposition to the bill. Written testimony in opposition to the bill was received from HIAA, Trigon, The Virginia Chamber of Commerce, HealthKeepers, CIGNA HealthCare of VA, Colonial Life and Accident Insurance Company, VAHMO, and the Virginia Manufacturers Association (VMA).

The Advisory Commission concluded its review of House Bill 1233 on September 19, 1996.

SUMMARY OF PROPOSED LEGISLATION

House Bill 1233 adds § 38.2-3407.5:1 to the Code of Virginia in the chapter on accident and sickness insurance. The bill requires any insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical or major medical coverage on an expense incurred basis; any corporation providing individual or group accident and sickness subscription contracts; and any health maintenance organization (HMO) providing a health care plan for health care services, whose policy, contract or plan, includes coverage for prescription drugs on an outpatient basis, to provide in each policy, contract, plan, or certificate, and evidence of coverage that such benefits will not be denied for any drug approved by the United States Food and Drug Administration (FDA) for use as a contraceptive. Each policy, contract, plan, certificate, or evidence of coverage shall include coverage for a variety of FDA-approved prescription contraceptives.

In the event the patient's physician determines that none of the methods designated by the policy, contract, plan, certificate, or evidence of coverage are medically appropriate for the patient, the plan shall also provide coverage for another medically approved prescription contraceptive method prescribed by the patient's physician. As currently drafted, it is not clear whether the bill was intended to include coverage for contraceptive devices.