H.B. 1563

VETOES

(B) EXCEPT FOR PRIVILEGED AND CONFIDENTIAL MEDICAL INFORMATION,
AS DETERMINED BY THE HEALTH CARE ACCESS AND COST COMMISSION, EACH
REGIONAL HEALTH COOPERATIVE SHALL:

(1) MAKE AVAILABLE FOR PUBLIC INSPECTION AT THE OFFICE OF THE
REGIONAL HEALTH COOPERATIVE DURING REGULAR BUSINESS HOURS EACH
REPORT FILED AND EACH SUMMARY, COMPILATION, AND REPORT REQUIRED
UNDER THIS SUBTITLE; AND

(2) MAKE AVAILABLE TO ANY STATE AGENCY ON REQUEST EACH
SUMMARY, COMPILATION, AND REPORT.

711. REGIONAL HEALTH COOPERATIVES - CONTRACTS FOR CONSULTING;

ASSUMPTION OF RISK PROHIBITED.

(A) UNLESS PERMISSION IS GRANTED SPECIFICALLY BY THE REGIONAL .
HEALTH COOPERATIVE, A THIRD PARTY HIRED BY A REGIONAL HEALTH
COOPERATIVE MAY NOT RELEASE, PUBLISH, OR OTHERWISE USE ANY
INFORMATION TO WHICH THE THIRD PARTY HAS ACCESS UNDER ITS CONTRACT.

(B) EXCEPT FOR THE PURCHASE OF HEALTH BENEFITS FOR ITS OWN
EMPLOYEES, A REGIONAL HEALTH COOPERATIVE MAY NOT PURCHASE HEALTH
CARE SERVICES, ASSUME THE RISK FOR COST OR PROVISION OF HEALTH CARE
SERVICES, OR OTHERWISE CONTRACT WITH HEALTH CARE PROVIDERS FOR THE
PROVISION OF HEALTH CARE SERVICES.

742. REGIONAL HEALTH COOPERATIVES CARRIERS' SUBMISSION OF CONTRACTS.

(A) (1) EACH REGIONAL HEALTH COOPERATIVE SHALL ACCEPT

CONTRACTS OF QUALIFIED CARRIERS TO PROVIDE HEALTH BENEFIT PLANS TO:

(I) ELIGIBLE EMPLOYEES OF MEMBER EMPLOYERS AND THEIR
DEPENDENTS; OR

(II) INDIVIDUALS.

(2) (I) PARTICIPATING CARRIERS SHALL SUBMIT THEIR PREMIUM
RATES FOR THE HEALTH BENEFIT PLAN AND EACH SUPPLEMENTAL BENEFIT
OFFERED THROUGH THE REGIONAL HEALTH COOPERATIVE ANNUALLY, ON OR
BEFORE A DATE ESTABLISHED JOINTLY BY ALL THE REGIONAL HEALTH
COOPERATIVES.

(II) IF THE REGIONAL HEALTH COOPERATIVES CANNOT AGREE
ON A DATE FOR SUBMISSION OF RATES, THE INSURANCE COMMISSIONER SHALL
ESTABLISH THE DATE FOR SUBMISSION OF RATES TO THE REGIONAL HEALTH
COOPERATIVES.

(3)      EACH RATE SUBMISSION SHALL BE SEALED AND CONSIDERED
CONFIDENTIAL UNTIL ALL RATES HAVE BEEN SUBMITTED.

(4)      (I) EXCEPT AS PROVIDED IN ITEM (II) OF THIS PARAGRAPH,
SUBMITTED RATES ARE FINAL AND SHALL NOT BE ADJUSTED BY EITHER THE
PARTICIPATING CARRIER OR THE REGIONAL HEALTH COOPERATIVE.

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