Health care; explanation of benefits, sensitive health care services.

Health care services; explanation of benefits. Requireshealth carriers and Medicaid managed care organizations to provide anexplanation of benefits to covered persons or recipients. The measure requiresthe State Corporation Commission to adopt regulations that establishalternative methods of delivery of the explanation of benefits that permit thereceipt of an explanation of benefits by an alternative method, provided thatsuch alternative method is in compliance with the provisions of federalregulations regarding the right to request privacy protection for protectedhealth information. The measure requires health carriers and Medicaid managedcare organizations to take all reasonable actions to ensure that their internalprocesses and systems prohibit the identification or description of sensitivehealth care services in their explanations of benefits. The measure requires ahealth carrier that requires a covered person to make a request forconfidential communications in writing in accordance with federal law to acceptthe form of the explanation of benefits approved by the Commission. The measurealso requires the Commission to define "sensitive health careservices." The measure will take effect 90 days after the Commission hasadopted the required regulations. The measure is a recommendation of the JointCommission on Health Care.