Rep. Norm Thurston — Voting Record

Bill

Number

S.B. 271 (2015GS)

Sponsor

Sen. Bramble, C.

Final action

Governor Signed 3/30/2015

Outcome

Became law — signed by Gov. Gary R. Herbert

Summary

What it does

• This bill:
• defines terms;
• prohibits denial of coverage under a health benefit plan because of life expectancy or a terminal condition under certain circumstances;
• provides that the prohibition may not be interpreted to require an insurer to offer a particular benefit or service as part of a health benefit plan or alter certain policies of a health benefit plan;
• provides that the prohibition provisions do not create a new or additional private right of action; and
• makes technical and conforming changes.

Every vote on this bill

Bill text

HEALTH BENEFIT PLAN AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Curtis S. Bramble
House Sponsor: 
James A. Dunnigan
LONG TITLE
General Description:
This bill addresses provisions related to a health benefit plan.
Highlighted Provisions:
This bill:
▸ defines terms;
▸ 
prohibits denial of coverage under a health benefit plan because of life expectancy
or a terminal condition under certain circumstances;
▸ provides that the prohibition may not be interpreted to require an insurer to offer a
particular benefit or service as part of a health benefit plan or alter certain policies
of a health benefit plan;
▸ provides that the prohibition provisions do not create a new or additional private
right of action; and
▸ makes technical and conforming changes.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
ENACTS:
31A-22-644
, Utah Code Annotated 1953
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
31A-22-644
 is enacted to read:
 31A-22-644.
Denial of coverage under a health benefit plan because of life
expectancy or terminal condition.
(1) As used in this section:
(a) "Health benefit plan" means the same as that term is defined in Section 
31A-1-301
.
(b) "Terminal condition" means an irreversible condition:
(i) caused by disease, illness, or injury; and
(ii) if:
(A) the irreversible condition will result in imminent death within a six-month period
after the date the condition is diagnosed; and
(B) the application of life-sustaining treatment only prolongs the process of dying.
(2) This section applies to a health benefit plan under:
(a) this part; or
(b) Chapter 8, Health Maintenance Organizations and Limited Health Plans.
(3) Except as provided by law, and subject to the other provisions of this section, a
health benefit plan may not deny coverage for medically necessary treatment if the medically
necessary treatment is:
(a) prescribed by a physician;
(b) agreed to:
(i) by a person who is:
(A) insured under the health benefit plan; and
(B) fully informed regarding the person's life expectancy or diagnosis with a terminal
condition; or
(ii) if the person described in Subsection (3)(b)(i) lacks legal capacity to consent, by
another person who:
(A) has legal authority to consent on behalf of the person described in Subsection
(3)(b)(i); and
(B) is fully informed regarding the life expectancy or diagnosis with a terminal
condition of the person described in Subsection (3)(b)(i); and
(c) denied solely because:
(i) of the life expectancy of the person described in Subsection (3)(b)(i); or
(ii) the person has been diagnosed with a terminal condition.
(4) A denial of coverage described in Subsection (3) for medically necessary treatment
is a violation of this section.
(5) Whether treatment is considered to be medically necessary treatment is determined
by the defined standards and policies of the health benefit plan.
(6) This section may not be interpreted to:
(a) require an insurer to offer a particular benefit or service as part of a health benefit
plan; or
(b) alter the clinical policies of a health benefit plan regarding the appropriate location
for services.
(7) This section does not create a new or additional private right of action.