Sen. Terry Link

Filed: 3/6/2017

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 193

2    AMENDMENT NO. ______. Amend Senate Bill 193 on page 1, by
3replacing lines 13 and 14 with "preventative physical therapy
4for insureds diagnosed with multiple"; and
 
5on page 2, line 2, after "requirements", by inserting "or other
6limitations"; and
 
7on page 2, immediately below line 5, by inserting the
8following:
 
9    "A group or individual policy of accident and health
10insurance or managed care plan amended, delivered, issued, or
11renewed after the effective date of this amendatory Act of the
12100th General Assembly shall offer an exception process from
13treatment limitations for individuals diagnosed with primary
14or secondary progressive multiple sclerosis. The exception
15process must be posted on the insurer's website in an

 

 

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1easily-accessible location. An exception request must document
2medical necessity for extended treatment that is reasonable and
3appropriate to the individual's defined goals included in his
4or her treatment plan. A health insurer shall, within 72 hours
5after receiving the exception request, either approve or deny
6the request.
7    The coverage required by this Section shall be subject to
8other general exclusions and limitations of the policy,
9including coordination of benefits, participating provider
10requirements, restrictions on services provided by family or
11household members, utilization review of health care services,
12including review of medical necessity, case management,
13experimental or investigational treatments, and other managed
14care provisions.".