VOL II, ISSUE 2, APRIL 2007

ADDRESSING: CURRENT BEST VALUES IN HEALTH INSURANCE; DECLINATION DUE TO PRE-EXISTING CONDITIONS; DIABETES CONTROL; BODY MASS INDEX; COBRA; MATERNITY COVERAGE; COST CONTROL RELATIVE TO HEALTH INSURANCE PREMIUMS; MEDIGAP COVERAGE; PRESCRIPTION DRUG PLANS; TOBACCO USER OPTIONS

THE MEDPLUS MESSENGER is published quarterly for the dissemination of information regarding health and life insurance laws; trends; products and related topics. It is intended to be of use to clients and prospective clients of ALL PLAN MED & LIFE QUOTE http://www.allplaninsurance.com (parent company of ALLPLANINSURANCE.COM; ALLPLANHEALTHINSURANCE.COM and ALLPLANINTERNATIONALHEALTHINSURANCE.COM) as well as residents of all fifty states (US) and the international community. It is a by-product of our responsibility to monitor the state of the national and international insurance environment and to inform the public of such matters. ALL PLAN MED & LIFE QUOTE has been based in The Woodlands, Texas since 1991.

THE MEDPLUS MESSENGER is not copyrighted and articles and analysis presented in THE MEDPLUS MESSENGER may be reproduced at your discretion. However, articles and analysis should not be construed as representing the policy, endorsement or opinion of ALL PLAN MED & LIFE QUOTE, or its agents, unless so stated. Although carefully verified, data are not guaranteed as to accuracy or completeness. ALL PLAN MED & LIFE QUOTE cannot be held directly responsible for any direct or incidental loss incurred by applying any of the information in this publication.

DIRECT QUESTIONS OR SUGGESTIONS TO FIELD OFFICES:
CALIFORNIA: 800-484-3792 CODE 1866; insurnet@snowcrest.net
NEW YORK: 888-766-6932; sonny@onestopshopping.com
TEXAS & ALL OTHERS: 800-856-6556; insurnet@verizon.net

IMPORTANT PHONE NUMBERS AND LINKS:
CENTERS FOR MEDICARE & MEDICAID SERVICES: 1-800-633-4227; http://www.medicare.gov
Texas Department of Insurance: 800-252-3439; http://www.tdi.state.tx.us/
Texas Health Insurance Risk Pool (for those uninsurable by private health insurance):
888-398-3927; TDD 1-800-735-2989; http://txhealthpool.com/
Texas Risk Pool Rates; Outline of Coverage; Application; Network of Providers
North Carolina Department of Insurance: 919-733-7487; http://www.ncdoi.com/
New York Department of Insurance: 800-342-3736; http://www.ins.state.ny.us/
Illinois Department of Insurance: 217-782-4515; http://www.idfpr.com/
Indiana Department of Insurance: 317-232-2410; http://www.state.in.us/idoi/
California Department of Insurance: 916-322-3555; http://www.insurance.ca.gov/
United States Treasury 2007 Health Savings Account Guidelines: http://www.treas.gov/offices/public-affairs/ha/
Legislative Information: http://www.nahu.org/

VISIT OUR WEB SITES AT: http://allplaninsurance.com http://allplanhealthinsurance.com http://allplaninternationalhealthinsurance.com

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FEATURE ARTICLE:

OBESITY - (A NATIONAL EPIDEMIC) IMPACTS INSURABILITY

New US School Food Standards To Tackle Obesity*

By now it should be common knowledge that obesity is an epidemic in the United States. It is one of the leading causes of "declination" for individual health insurance coverage in almost every state. Insurance companies simply cannot ignore the evidence that obesity opens the door for a host of debilitating and costly health problems not the least of which are diabetes and heart disease.

In an effort to tackle the rising obesity problem in American youth, the US Institute of Medicine (IOM) has issued a voluntary nutrition standard for "competitive" food and drinks sold in schools alongside the healthy school meals program which is already covered by federal nutrition guidelines.

The rise in US childhood obesity prompted a concerned Congress to approach the IOM to recommend standards for school food.

The aim is to improve the health of all children in school by encouraging them to eat more fruits, vegetables and whole grains and avoid added sugar, salt and saturated fat.

To "read on" and see the article (New US School Food Standards To Tackle Obesity Main Category: Pediatrics / Children's Health News Article Date: 26 Apr 2007 - 0:00 PDT) in its entirety - please click on the following link:

http://www.medicalnewstoday.com/healthnews.php?newsid=69021

*FOR INFORMATIONAL PURPOSES ONLY AND TO OBTAIN WHAT ARE FAIRLY STANDARD HEIGHT AND WEIGHTS ACCEPTED BY INSURANCE COMPANIES FOR INSURABILITY PURPOSES, PLEASE CLICK HERE TO OPEN A PDF CONTAINING ONE COMPANIE'S "HEIGHT AND WEIGHT CHART" FOR ADULTS:

TIPS FOR FIGHTING OBESITY:

To assist all of us in fighting to keep obesity from becoming an issue of ourselves and families - The Mayo Clinic offers the following advice.

The healthiest foods qualify as such because they meet at least three of the following criteria:

• Are a good or excellent source of fiber, vitamins, minerals and other nutrients
• Are high in phytonutrients and antioxidant compounds, such as vitamins A and E and beta carotene
• May help reduce the risk of heart disease and other health conditions
• Are low in calorie density, meaning you get a larger portion size with a fewer number of calories
• Are readily available

To see "The 10 Healthiest Foods" and read the article in its entirety - please click on the following link:

http://www.mayoclinic.com:80/print/health-foods/NU00632/METHOD=print

FLASH BULLETIN #1:

UniCare's Parent Company - WellPoint - Ranked First Overall in Health Insurance and Managed Care!

CLICK HERE FOR A REPRINT OF THE FORTUNE MAGAZINE MARCH 19, 2007 ARTICLE CITING WELLPOINT:

BLUECROSS BLUESHIELD

Understanding your insurance coverage can be difficult. BlueCross BlueShield's new "HEALTH PLAN COST ESTIMATOR" tool will show you the cost impact of your coverage decisions. Considering these costs will help you make the best choices for your needs and find the best plan for your budget.

CLICK HERE TO PUT THE TOOL TO WORK FOR YOU:
https://www1.subimo.com/cav4/app/hcsc/CoverageAdvisor?corpEntCd=TX1

To see a demo of Anthem's exciting new demo of their consumer driven health plans which assist you in evaluating and maintaining a healthy lifestyle and getting the most from your insurance coverage - click here: MyAnthem Lumenos Demo
http://www22.anthem.com/member/anthem/demo/index.html

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NEW HEALTH CARE WEBSITE FOR CONSUMERS:
http://www.txpricepoint.org

Texas health care consumers now can view and compare charge data on inpatient hospital services provided at Texas hospitals through a new, consumer-friendly website, Texas PricePoint (http://www.txpricepoint.org/). The site includes charge data on the most common inpatient services, links to quality data and general and contact information On all Texas hospitals. Users can request information on a single hospital or from several to allow comparisons. Once a hospital’s information is displayed, users can click on a link to the hospital’s own website, if one exists, where they can find more specific information on hospital billing policies, patient rights and responsibilities.

For pertinent news and links from the National Association of Health Underwriters:
http://www.nahu.org/consumer/healthcare/

Employer-Based Health Insurance Coverage
http://www.nahu.org/consumer/healthcare/topic.cfm?catID=1

The majority of Americans have group health insurance coverage through either their employer, or the employer of a family member. This section is designed for consumers who need more information about what requirements apply to group health insurance coverage, or need to know what their options are if they are about to lose access to their group coverage. It also provides contact information for the state and federal regulators who oversee private group health insurance in America, in case consumers have questions or need to report a problem. Consumers who are looking to purchase a group health insurance product can go to NAHU's Find An Agent feature to find an NAHU member in their area to assist them in obtaining coverage.

ARE "GROUP" HEALTH INSURANCE PREMIUMS LOWER THAN "INDIVIDUAL AND FAMLILY" INSURANCE PREMIUMS?

Due to new health insurance laws which have forced coverage for pre-existing conditions on group insurance plans, group costs are generally anything but lower than those for individual and family coverage. So - if health problems are not an issue - your better value is in individual / family coverage. The bad news is - you can still be declined for such or have your pre-existing conditions "waived" or "ridered-out" of coverage. If such is your case, group coverage may be your only hope of acquiring full coverage.

If you are self-employed or own your own business and desire group coverage, in most states you will have to:

1) Provide a "quarterly wage and tax report" from the state where your business is domiciled - substantiating that the people to be covered are actual "employees" and not 1099 (contract workers).

2) You (the employer) will have to commit to paying a minimum of 50% of the employee's insurance premium

3) You (the employer) must sign to the effect that your are covering a minimum of 50% of your employee's not covered by a spouse's group plan (which they will have to document).

If "Individual" Health Insurance Coverage is your preference or only option:
http://www.nahu.org/consumer/healthcare/topic.cfm?catID=2

Many Americans who do not have access to group health insurance coverage, like self-employed people, early retirees, students and people whose employers do not offer health benefits, choose to purchase their own coverage privately. The laws concerning individual health insurance products are different than the laws regulating group coverage, and the requirements vary significantly on a state-by-state basis. This section helps consumers understand how individual insurance is regulated in their area, and it also helps explain the state-specific options available to individual consumers who have serious medical conditions that may preclude them from obtaining traditional coverage. Furthermore, this section contains information about the entities that regulate the individual market, so that consumers can contact them if they have questions or concerns. People who are looking to purchase health insurance on an individual basis can go to NAHU's Find An Agent feature to find an NAHU member in their area to help them buy coverage.

Assistance for Obtaining Health Coverage
http://www.nahu.org/consumer/healthcare/topic.cfm?catID=3

Many Americans need to obtain health care services but may have trouble paying for them. This section provides comprehensive information about all of the major federal and state programs to provide coverage assistance to individuals age 65 and under. It includes specifics and contact information for large-scale programs like Medicaid, the State Children's Health Insurance Program and the federal Health Care Tax Credit Program. In addition, this section contains overviews and contacts for the hundreds of smaller state and federal-level and private programs that provide coverage assistance and services to specific populations. This section may be a particularly helpful resource to people with lower incomes who are either uninsured or under-insured, and to people who are looking for either primary care or preventive assistance or help with a serious medical condition, as many of these programs target those groups.

LEGISLATIVE NEWS:

TEXAS:

FREW SETTLEMENT: The state has agreed to a $700 million settlement in Frew v. Hawkins, a thirteen-year-old lawsuit against the state in which plaintiffs argued that Texas has not sufficiently funded Medicaid programs. Under the settlement, the Medicaid reimbursement rate for physicians would increase by 25%, and the reimbursement rate for dentists would increase by 50%. The settlement also increases the availability of medical and dental care in rural areas; adds to the availability of efficient toll-free hotlines; and boosts access to medication and medical equipment under a provision that applies to pharmacies. The settlement is subject to the approval of U.S. District Judge William Wayne Justice, who gave attorneys until April 27 to submit a final draft of the agreement. The lead attorney for the plaintiffs has asked the judge to wait until after the legislative session ends on May 28 before signing off on the settlement.

BUDGET: On Tuesday, April 10, the Senate Finance Committee voted out its version of HB 1, the General Appropriations Bill. Prior to voting out the bill, the committee adopted an amendment reducing general revenue and general revenue-dedicated appropriations to all agencies and institutions by $465.9 million. The Senate version of HB 1 includes $38.8 billion in all funds ($15.5 billion in general revenue and general revenue dedicated funds) for the Medicaid program (compared with the House version, which includes $36.9 billion in all funds and $14.7 billion in general revenue funds.) This represents an increase of $2.0 billion in general revenue and general revenue–dedicated funds for Medicaid services at all health and human services agencies to address caseload increases, fund acute care cost growth, fund a full biennium of Medicare Giveback (clawback) payments, reduce community care waiting lists and fund rate restorations and increases. It includes $1.8 billion in all funds ($574.6 million in general revenue funds) for the Children’s Health Insurance Program (CHIP), whereas the House version has $2.1 billion in all funds and $630.1 million in general revenue for CHIP. This represents an increase of $239.6 million in general revenue funds to provide two full years of perinatal (prenatal and postnatal services) and dental premiums, address caseload increases, fund cost growth, and fund rate restorations and increases. The Senate passed the Finance Committee’s substitute to HB 1 on April 12. On April 17, the House refused to concur with the Senate amendments. STATUS: House conference committee appointed on 4/17/07.

MEDICARE FUNDING FOR HEALTH INSURANCE COUNSELING: The Centers for Medicare & Medicaid Services (CMS) announced April 11 that Medicare will provide funding for health insurance counseling in every state to help beneficiaries get the most from the health program for elderly and disabled persons. Each state will receive a share of $30 million in grant funds with the purpose of state agencies having the ability to bring personalized assistance to people with Medicare at the local level. Under the State Health Insurance Assistance Programs (SHIPs), SMS provides funding to 54 SHIPs, including all 50 states and the District of Columbia, Puerto Rico, Guam and the Virgin Islands. SHIP counselors will continue to provide enrollment assistance to Medicare beneficiaries and offer personalized counseling regarding all of their Medicare benefits, including new preventative health screenings and services.

FULL HOUSE ACTION:

The House passed the following legislation:

HB 1056 by Vicki Truitt (R-Southlake) would require the Statewide Health Coordinating Council to collect data on each health professional including name, last four digits of social security number, certification and licensure information, biographical information, educational background and training, and practice information. This bill was reported as substituted from the House Public Health Committee on 4/10/07. STATUS: Passed by the House on 4/19/07.

HB 1683 by Chuck Hopson (D-Jacksonville) would delete Section 568.006 of the Occupations Code, which requires the ratio of pharmacists to pharmacy technicians in a Class A pharmacy to be one to five. STATUS: Passed in the House on 4/13/07. Received in the Senate and referred to the Senate Committee on Health and Human Services on 4/19/07.

FULL SENATE ACTION:

The Senate passed the following legislation:

SB 10 by Jane Nelson (R-Lewisville) (Companion is SB 2404/Delisi) relating to the operation and financing of the medical assistance program and other programs to provide health care benefits and services to persons in this state and providing penalties. The bill aims to contain Medicaid costs by shifting money to preventative health care. The bill passed the Senate on 4/17/07. It was received in the House on 4/18/07 and referred to the House Appropriations Committee. STATUS: Passed the Senate on 4/17/07. Received in the House on 4/18/07 and referred to the House Appropriations Committee. Committee action pending 4/19/07.

SB 409 by Kyle Janek (R-Houston) (Companion is HB 1806/Gattis) would prevent a pharmacist from dispensing a generic substitution drug for the treatment of epilepsy or for the prevention of seizures, unless the pharmacist obtains a signed authorization from the prescribing physician authorizing the generic substitute. STATUS: Passed the Senate 4/16/07. Received by the House 4/17/07, not referred.

SB 419 by Lucio (D-Brownsville), (Companions are HB 1224/Davis, John and HB 3540/Garcia) defines Autism Spectrum Disorder (ASD) as a neurobiological disorder, not a serious mental illness. It requires ASD treatment to be covered by insurance for children ages three to five years. It provides that if the enrollee becomes six years of age or older and continues to need treatment, this section does not preclude coverage of treatment and services. A consumer choice health benefit plan is required to cover all generally recognized services prescribed in relation to ASD by the enrollee's primary care physician. Fiscal Note: The estimated two-year net impact to general revenue-related funds for SB419, as introduced: a negative impact of $1,303,392 through the biennium ending August 31, 2009 for the Employee Retirement System. To the extent that the provisions of the bill drive an increase in claims in the self-funded TRS-ActiveCare insurance program for public school employees, premiums in that program could increase. This bill also has potential cost implications for commercial insurance. STATUS: Passed the Senate on 4/19/07.

SB 943 by Kyle Janek (R-Houston) (Companion HB 2316/Truitt) relating to anti-seizure drugs. STATUS: Passed by the Senate 4/17/07; received in the House 4/18/07, not referred.

SB 994 by Jane Nelson (R-Lewisville) would authorize prescriptions for controlled substances to be communicated electronically, telephonically, or orally to a pharmacist. STATUS: Passed the Senate’s Local and Uncontested Calendar on 4/12/07; referred to the House Public Health Committee 4/13/07.

SB 1500 by Judith Zaffirini (D-Laredo) would designate the Donor Education, Awareness, and Registry Program of Texas as the Glenda Dawson Donate Life-Texas Registry. This bill was reported favorably on 4/17/07. STATUS: Passed by the Senate on 4/19/07.

COMMITTEE ACTION:

House Insurance Committee:

HB 522 by Beverly Woolley (R-Houston), which would require health benefit plans to issue an identification card or similar document to each enrollee that includes the name of the insurer, name of the administrator of the plan, name of the policyholder or group contract, number of the policy, telephone number or electronic address for insurance, and telephone number and electronic address for authorizations. This bill had been placed on the House calendar for 4/17/07, but it was recommitted to committee on 4/16/07. On 4/19/07, it was reported from the House Insurance Committee, as substituted. STATUS: Placed on the House Calendar for 4/24/07.

HB 634 by Craig Eiland (D-Texas City) would provide that if an individual accident and health insurance policy provides coverage for emergency or other medical, hospital, or surgical expenses incurred by an insured, it cannot prohibit coverage for any loss sustained because the insured was intoxicated or under the influence of a narcotic. STATUS: Left pending in the House Insurance Committee 4/17/07.

HB 1227 by John Smithee (R-Amarillo) would require health benefit plan issuers to use smart card technology to disseminate information to patients, physicians, and other providers. STATUS: Left pending in the House Insurance Committee on 4/16/07.

HB 1600 by Senfronia Thompson (D-Houston) (Companion is SB 730/Corona) would require the Texas Department of Insurance (TDI) to conduct a study of the maximum lifetime benefit limits under health benefit plan coverage for hemophilia-related services, supplies, pharmaceuticals, and biologics. STATUS: Reported favorably from the House Insurance Committee on 4/12/07.

HB 1847 by Kelly Hancock (R-North Richland Hills) would allow an insurer or health maintenance organization in connection with an accident or health insurance policy to provide health related services, health related information, or other programs promoting wellness, health promotion, disease prevention and to establish premium discounts, reduced co-payments, or a combination of incentives for wellness programs. STATUS: Reported favorably from the House Insurance Committee, as substituted, 4/17/07.

HB 2467 by Burt Solomons (R-Carrollton) would allow an insurer to modify a small or large employer health benefit plan if the modification occurs at the time of coverage renewal; the modification is effective uniformly among all small or large employers covered by that health benefit plan; and the issuer notifies the Commissioner of Insurance and each affected covered small or large employer at least 60 days before the modification takes effect. STATUS: Left pending in the House Insurance Committee 4/16/07.

HB 2483 by Jose Menendez (D-San Antonio) would authorize a health benefit plan issuer to operate a cross-border health benefit plan to provide health care services to an eligible enrollee. A cross-border health benefit plan would be allowed to offer and provide health care services only in the geographic regions composed of Texas and Mexico that are located within 75 miles of the border. STATUS: Left pending in the House Insurance Committee 4/16/07.

HB 2706 by John Smithee (R-Amarillo) (Companion SB 951/Hegar) relating to participation of hospitals in certain health care delivery networks. STATUS: Left pending in the House Insurance Committee on 4/16/07.

HB 3174 by Hubert Vo (D-Houston) relating to withdrawal and restriction plans for certain insurers. STATUS: Left pending in the House Insurance Committee on 4/16/07.

HB 3568 by Patrick Rose (D-Dripping Springs) would provide that the cost-sharing provisions of indemnity benefits under a point-of-service rider may not exceed an amount that would effectively prohibit the use of out-of-network providers. A health maintenance organization would be prohibited from: restricting or penalizing an enrollee for using an out-of-network provider other than by imposing higher cost-sharing; terminating participation of a physician or provider because the physician or provider informs an enrollee of the full range of physicians and providers available to the enrollee, including out-of-network providers; or penalize a physician or provider for not limiting medically necessary services or for providing information regarding the availability of facilities, both in-network and out-of-network for the treatment of a patient’s medical condition. STATUS: Left pending in the House Insurance Committee 4/16/07.

HB 3933 by Hubert Vo (D-Houston) relating to regulation of payment of health care providers. STATUS: Left pending in House Insurance Committee 4/16/07.

House Public Health Committee:

SB 204 by Jane Nelson (R-Lewisville) would require medical records software systems sold to a person who administers immunizations to interface with the state’s immunization system. STATUS: Left pending in the House Public Health Committee 4/18/07.

SB 625 by Kyle Janek (R-Houston), which would prohibit a pharmacist from dispensing a drug for immunosuppressive therapy following a transplant unless the drug is the specific formulation and manufactured by the specific manufacturer that is prescribed by the patient’s physician. A generic substitution could only be made if the prescribing physician gives written permission. STATUS: Referred to the House Committee on Public Health 4/13/07.

SB 810 by Kyle Janek (R-Houston) would authorize a health authority to designate health care facilities within the health authority’s jurisdiction that are capable of providing services for the examination, observation, quarantine, isolation, treatment, or imposition of control measures during a public health disaster or during an area quarantine. This bill passed the Senate on 4/12/07 and was received in the House the same day. STATUS: Referred to House Public Health Committee on 4/13/07.

SB 994 by Jane Nelson (R-Lewisville) would authorize prescriptions for controlled substances to be communicated electronically, telephonically, or orally to a pharmacist. This bill was passed by the Senate on 4/12/07. STATUS: Referred to the House Public Health Committee 4/13/07.

HB 1066 by Dianne White Delisi (R-Temple) would create the Texas Health Service Authority Corporation to promote the establishment of a privacy-protected and secure, integrated statewide network for the communication of electronic health information among authorized parties and to foster a coordinated public-private initiative for the development and operation of the health information infrastructure of Texas. STATUS: Pending in the House Public Health Committee on 4/18/07.

HB 1370 by Garnet Coleman (D-Houston) would change the makeup of the Interagency Coordinating Council for HIV and Hepatitis and would require them to develop a plan that facilitates coordination of agency programs based on statistical information regarding the State of Texas prevention of AIDS, HIV infection, and hepatitis and provision of services to individuals who have hepatitis or are infected with HIV. This bill was reported as substituted from the House Public Health Committee on 4/10/07. STATUS: Recommended for the Local and Consent Calendar on 4/10/07.

HB 1373 by Ryan Guillen (D-Rio Grande City) would create the Chronic Kidney Disease Task Force administered by the Department of State Health Services to develop a plan to educate health care professionals about methods of early screening diagnosis and treatment of chronic kidney disease and educate individuals with chronic kidney disease about the advantages of end-stage renal disease modality education and early renal replacement therapy. The bill was reported favorably as substituted from the House Public Health Committee on 4/10/07. STATUS: Passed to third reading in the House on 4/19/07.

HB 1398 by Dianne Delisi (R-Temple) would establish the Advisory Panel on Health Care-Associated Infections within the infectious disease surveillance and epidemiology branch of the Department of State Health Services to guide the implementation, development, maintenance, and evaluation of the reporting system. The bill was reported favorably as substituted from the House Public Health Committee on 4/10/07. It was laid out for consideration in the House on 4/18/07. STATUS: Postponed on second reading until 5/2/07.

HB 1443 by John Davis (R-Houston), which would prohibit a pharmacist from dispensing a drug for immunosuppressive therapy following a transplant unless the drug is the specific formulation and manufactured by the specific manufacturer that is prescribed by the patient’s physician, was reported favorably as substituted from the House Public Health Committee on 4/10/07 and set on the House Calendar 4/18/07. STATUS: Set on the House Calendar for 4/23/07.

HB 1953 by David Leibowitz (D-San Antonio) would require prescriptions to be labeled with the name address and telephone number of the pharmacy; the date the prescription is dispensed; the name of the prescribing practitioner; the name of the patient, or if the drug was prescribed for an animal, the species of the animal and the name of the owner; instructions for use; the quantity dispensed; the date after which the prescription should not be used; the actual drug dispensed; and any other information required by the Texas State Board of Pharmacy. STATUS: Reported favorably as substituted from the House Public Health Committee on 4/10/07.

HB 2145 by Jodie Laubenberg (R-Wylie) would designate the Donor Education, Awareness, and Registry Program of Texas as the Glenda Dawson Donate Life-Texas. STATUS: Voted favorably from the House Public Health Committee, as substituted, 4/18/07.

HB 2855 by John Davis (R-Houston) would require the Department of State Health Services to publish on the department’s Internet website outcome data for each health care facility that submits data to the Health Care Information Council that includes patient length of stay; mortality; co-morbidity; complications; infection rates; and patient charges for specific conditions and procedures. STATUS: Left pending in the House Public Health Committee 4/11/07.

HB 2964 by Garnet Coleman (D-Houston) (Companion is SB 1388/Van de Putte) would require the Health and Human Services Commission to provide mental health services for a 12-month period following the birth of a child to a woman who is eligible for medical assistance and is diagnosed with postpartum depression. STATUS: Left pending in the House Public Health Committee on 4/11/07.

HB 3814 by John Zerwas (R-Richmond) (Companion is SB 1597/Janek) is the Revised Uniform Anatomical Gift Act. It would allow authorization for an anatomical gift of a donor’s body or part to be made by the donor; an agent of the donor; a parent of the donor or the donor’s guardian. STATUS: Left pending in the House Public Health Committee 4/11/07.

HB 3886 by Dan Gattis (R-Georgetown) would require hospitals associated with an academic medical center or health science center that uses an electronic health record system or a hospital receiving payments through the medical assistance program to allow community-based health care providers to remotely access and use its electronic health record system (for a fee). STATUS: Left pending in the House Public Health Committee on 4/18/07.

Senate Health and Human Services Committee:

SB 368 by Ellis (D-Houston) (Companion is HB 9/Crownover) relating to the elimination of smoking in all workplaces and public places. Blue Cross and Blue Shield of Texas supports this bill. STATUS: Pending in the Senate Health and Human Services Committee 4/19/07.

SB 415 by Eddie Lucio, Jr. (D-Brownsville) (Companion is HB 1363/McReynolds) would require the Texas-Mexico Border Health Coordination Office to administer a risk assessment program for Type 2 diabetes for individuals who attend public or private schools. This bill was reported, as substituted, from the Senate Health and Human Services Committee 4/19/07. STATUS: Recommended for the Senate Local & Uncontested Calendar 4/19/07.

SB 556 by Eddie Lucio, Jr. (D-Brownsville), would create the State Obesity Council, which would be composed of the Commissioner of Agriculture, Commissioner of State Health Services and Commissioner Education (or their designees). The purpose of the State Obesity Council would be to discuss the status of each agency’s programs geared toward promoting better health and nutrition and preventing obesity among children and adults, and to consider the feasibility of tax incentives for employers who promote activities designed to reduce obesity in the workforce. This bill was reported from the Senate Health and Human Services Committee on 4/16/07. STATUS: Recommended for the Local/Uncontested Calendar 4/16/07.

SB 1090 by Robert Duncan (R-Lubbock), would create a youth diabetes registry. This bill was reported from the Senate Health and Human Services Committee and recommended for the Local/Uncontested Calendar 4/16/07. STATUS: Placed on Senate Intent Calendar for 4/23/07.

HB 1098 by Bonnen (R-Angleton) would prohibit the state from adding the HPV vaccine to the list of shots required for school attendance. When the bill was heard in the Senate Committee on Health and Human Services, the committee added a provision that would prompt lawmakers to review the ban in 2011. The committee voted the bill favorably, as substituted. STATUS: Placed on Senate Intent Calendar for 4/23/07.

Senate State Affairs Committee:

SB 1391 by Carlos Uresti (D-San Antonio), relating to requirements in certain health benefit plans that certain health care services must be obtained in a foreign country. STATUS: Pending in the Senate State Affairs Committee on 4/19/07.

SB 1637 by Williams (Companion is HB 3366/Straus), relating to a small employer health benefit plan premium assistance program. (See Digest of 4/3/07 for bill summary.) STATUS: Pending in the Senate State Affairs Committee on 4/19/07.

SB 380 by Van de Putte (Companion is HB 1227/Smithee), relating to the regulation of health benefit plan issuers and dissemination of information to patients, physicians, and other providers. See Digest of 2/16/07 for bill summary.) STATUS: Voted favorably from the Senate State Affairs Committee, as substituted, on 4/19/07.

SB 1731 by Duncan (Companion is HB 3530/Isett) relating to consumer access to health care information and consumer protection for services provided by or through health benefit plans, hospitals, ambulatory surgical centers, and birthing centers; providing penalties. STATUS: Voted favorably from the Senate State Affairs Committee, as substituted, on 4/19/07.

Upcoming Committee Meetings:

The House Committee on Insurance will meet on Monday, April 23, 2007. The following bills are among those set for hearing:

HB 2548 by Todd Smith, relating to limitations in health plans.

HB 2551 by Todd Smith, relating to refund of excessive premium.

HB 2552 by Todd Smith, relating to reporting requirements for group health plans.

HB 2640 by Smithee, relating to use of information by insurers.

Additional information can be obtained via the Senate and House websites:

http://www.senate.state.tx.us

http://www.house.state.tx.us

WHAT'S NEW IN THE MEDPLUS MESSENGER SINCE OUR LAST ISSUE:

1) ADDITION OF "LEGISLATIVE" SECTION

A significant portion of health insurance premiums are based on legislative mandates. Likewise, legislation and law are often the only way essential coverage can be guaranteed. In this section, it is our objective to high-light the most recent and pertinent action impacting the insurance market place and consumer.

Will also contain key links to more specific information and contacts.

2) Of Special Interest to Residents of Texas with "PRE-EXISTING" HEALTH CONDITIONS:

THE TEXAS HEALTH INSURANCE RISK POOL PLAN, ADMINISTERED BY BLUE CROSS AND BLUE SHIELD OF TEXAS, IS FOR THOSE UNINSURABLE BY PRIVATE HEALTH INSURANCE PLANS

If you have been declined for private health insurance due to pre-existing medical conditions or - had your pre-existing medical condition "waived" for coverage - the risk pool plan may be available to you.To obtain rates; requirements to obtain coverage and an application, simply click on the appropriate file:

A) RATES

B) OUTLINE OF COVERAGE

C) APPLICATION

D) NETWORK PROVIDERS: http://www.bcbstx.com/onlinedirectory/ppo.htm

If you have questions - or for instructions on how to possible expedite your application process - please call us at: 800-856-6556

ALL PLAN MED & LIFE QUOTE and ALLPLANINSURANCE.COM sincerely appreciate your business and will continue to provide your lowest cost health and life insurance options and the best of on-going service.

We hope this issue of THE MEDPLUS MESSENGER has proved useful to you and that you'll look forward to future issues. As always, we'll try to keep you informed of all that's relevant in this particular sector of the insurance market which constitutes such a significant portion of your family or business overhead.

Until then, take care and please let us hear from you.

Sincerely,
Kenton Henry
President
PHONE: 800-856-6556
http://www.linkedin.com/in/kentonhenryinsurancebroker

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