SCS/SBs 807, 553, 574, 614, 747 & 860 - This act makes various changes regarding insurance law.

This act allows insurance companies to carry over deductions for examination fees to subsequent tax years. This section is similar to one contained in SB 807.

This act requires a professional boxing promoter to file proof of insurance of not less than $100,000 for each boxer with the department of economic development. If the promoter does not file proof of insurance, it will not be issued a permit or license to promote professional boxing matches. The insurance policy will cover any medical expense associated with a boxing injury. The insurance policy will also pay the boxer's estate if the boxing injury results in death. The proof of insurance requirements shall not apply to not for profit organizations sponsoring boxing contests. This provision is similar to one contained in SB 553 and in CCS/SS/HB 1292 (2000).

This act requires specific health plans to cover all services provided or ordered by registered nurse first assistants. Section 335.018 defines a "registered nurse first assistant" (RNFA) as a registered nurse, licensed in Missouri, who has received additional certification through a nationally- recognized professional organization to become a RNFA or who meets the criteria for RNFAs established by the Missouri State Board of Nursing. If so certified, then all services provided by RNFAs shall be covered by the specified health plans. These provisions are substantially similar to SB 574, CCS/SS/HB 1292 and HB 1133 (2000).

This act requires certain insurance companies to authorize or deny coverage for surgical procedures within certain time limits. These companies must reply to an enrollee's surgeon or primary care physician within forty-eight hours regarding the enrollee's eligibility for a surgery that has been pre-approved by the enrollee's physician. If the enrollee is deemed eligible for the surgical procedure, then the insurance company will be bound to its decision for thirty days following notification to the enrollee or to the enrollee's physician. Coverage of the surgical procedure will be subject to the same terms and conditions as applicable to other benefits. This provision is similar to one contained in SB 747 (2000).

This act requires health insurance carriers to use standardized forms for the explanation of benefits and referrals. Health carriers are required to use the explanation of Medicare Benefits Part B form for the explanation of benefits. The standardized referral form shall be developed by a task force established by the Department of Insurance. The standardized forms shall be used by health insurance carriers and providers after January 1, 2002. This portion of the act is similar to SB 120 (1999).

This act prohibits a health carrier from retracting its authorization of health care services unless that health carrier's coverage is secondary to other valid insurance coverage. This act also defines the term "authorization" for the purposes of utilization review. This portion of the act is similar to SB 860 (2000).
STEPHEN WITTE