►
Description
House Insurance Subcommittee - March 15, 2022 - House Hearing Room 2
A
B
A
A
I
will
take
a
moment
of
personal
privilege,
my
my
10
year
old
daughter,
caitlin,
is
here
and
to
my
left
to
everybody's
right.
She
has
been
diligently
walk
watching
the
work
that
we
do
and
she
has
lots
of
advice.
If
you
need
any
help
on
your
bills,
she
is
ready,
willing
and
able
to
to
help
anything.
A
A
A
We're
now
ready
to
address
item
number
three
on
our
calendars
house
bill
2048
house,
bill
2048
by
vice
chairman
jarnigan.
You
have
a
motion
and
a
second.
I
believe
we
have
a
an
amendment
that
we're
working
on
as
well.
Vice
chairman
jarnigan,
I
think
the
amendment
code
that
we'll
work
on
is
zero
one.
Four
one,
five
eight.
C
A
A
motion
and
a
second,
I
think,
we'll
go
ahead
and
get
ourselves
in
proper
posture,
all
those
in
favor
of
placing
amendment
coded
zero
one,
four
one,
five
eight
on
the
bill,
please
signify
by
saying
aye
any
opposed.
Please
say:
no,
the
ice
have
it
the
amendment's
on
your
bill,
you're
ready
to
describe
your
bill
to
us
as
amended.
Sir.
Thank
you
chairman.
C
C
C
So
basically
in
a
nutshell,
what
it
does
is
if
a
health
insurer
issues
a
prior
authorization
saying
we're
going
to
pay
100
of
this,
then
the
vendor
or
the
end
user,
such
as
myself,
will
not
be
responsible
for
any
mistakes
that
the
insurance
company
made.
Typically
there's
been
cases
where
afterwards
during
audit,
or
we
should
not
have
paid
that,
then
we
need
ten
thousand
dollars
back
well,
that's
your
expert
should
realize
that
on
the
front
end,
so
those
are
the
is
what
the
bill
does
like.
C
A
Chairman,
john
again,
I
do
realize-
and
you
and
I
have
this
conversation-
I
think
there
there
was
conversation
about
a
potential
untimely
filed
amendment
and
I
think,
there's
just
a
very
small
clarification
that
we're
going
to
be
looking
for.
Should
you
meet
with
a
positive
approval
in
this
committee
that
will
work
on
a
full
committee
that
will
that
will
include
language
that
the
department
of
commerce
and
insurance
has
suggested.
That
will
say
that
this
is
not
going
to
be
considered.
C
Yeah,
that's
correct
commerce.
Insurance
came
to
me
yesterday
about
45
minutes
for
our
amendments
to
be
found,
but
I
agree
with
their
assessment
that
they're
making
a
clarification.
It's
not
substantial
at
all
and
just
under
the
affordable
health
care
act,
you
can't
have
mandates.
They
just
wanted
the
language
to
say
this
is
not
a
mandate
and
it's
not
okay.
A
And
I'm
comfortable
if
the
committee
is
comfortable
allowing
that
to
allow
the
bill
to
go
forward
with
the
idea
that
we
will
have
that
revised
amendment
come
full
committee
question
has
been
called
all
those
in
favor
of
sending
house
bill
2048
to
full
insurance
committee.
Please
signify
by
saying
aye
any
of
those
posts.
Please
say
no
nice
have
it.
Thank
you
very
much
darren
chairman
members.
Thank
you.
Thank
you.
A
A
A
Right
we
have
a
motion
on
amendment
number,
one
that
is
coded
zero
one,
five,
seven
three
one
we'll
go
ahead
and
get
the
bill
in
the
posture
and
then
allow
you
to
describe
after
that.
If
it's
all
right,
sir,
all
those
we
did
have
a
motion
on
the
amendment.
Do
I
hear
a
second?
We
have
a
second
thank
you
very
much,
all
those
in
favor
of
placing
that
amendment
code
on
house
bill.
2625,
please
signify
by
saying
aye
any
opposed.
Please
say
no!
A
The
ice
have
it
now,
sir.
I
think
we're
in
the
proper
posture
now
and
as
that
is
the
latest
amendment
that
we've
been
discussing
and
I'll.
Let
you
go
from
there,
sir.
D
Thank
you,
chairman
hawk.
In
tennessee,
we
have
a
certain
population
of
citizens
who
are
eligible
for
both
medicare
and
medicaid.
We
might
call
them
dual
eligibles.
They
currently
have
six
different
options
with
which
to
receive
both
types
of
benefits,
medicare
and
medicaid,
or
medicare,
and
and
tend
care.
D
D
D
D
A
A
Ask
one
question,
and
you
may
not
have
got
deep
into
this
particular
amendment
chairman
obama.
I
know
we've
just
introduced
and
we're
just
trying
to
decipher
it
ourselves
we're
talking
about
earlier
dual
enrollees,
but
is:
could
this
potentially
affect
all
ten
carrolles?
Is
that
something
that
and
I'm
just
looking
at
section
two
of
the
bill,
which
is
on
page
one
that
there's
a
potential
that
this
the
delineation
of
one
fourth,
one
one-fourth
one-fourth
one-fourth
actually
could
affect
all
ten
caribolis
is
that
is
that
something
that
you're
it's
on
your
radar
screen
there,
sir?
I.
D
A
All
right,
thank
you
very
much,
sir,
and
sometimes
it
takes
my
hand
a
little
while
to
catch
up.
To
my
mind,
as
I'm
writing
notes
on
that.
Thank
you
very
much
and
I
think
there's
a
there's.
A
timing
mechanism-
that's
in
there
as
well
that
says
tinker
may
have
to
accomplish
this
rfp
in
a
30-day
window
and-
and
we
may
look
at
in
a
different
time
frame
as
well.
I
think
much
like
the
the
bill
that
we
just
passed
a
moment
ago.
The
the
chair
feels
comfortable.
A
So
I
think
we
do
have
a
a
framework
of
a
of
a
nice
bill
that
seems
to
be
supported
by
several
folks,
but
does
need
a
little
bit
of
work
that,
since
this
is
going
to
be
our
last
meeting,
that
that
we,
I
do
feel
comfortable
passing
it
on
the
full
committee.
Any
questions
or
comments
of
any
members,
dr
kumar
chairman
kumar,
you're,
recognized.
E
Certainly,
I
think
something
needs
to
be
done
along
the
lines,
but
as
we
move
to
full
committee,
I'd
like
you
to
think
about
the
objections
that
are
from
10k.
What
is
their
difficulty
with
it?
I'm
sure
you've,
given
it
some
thought
and
also
25
percent
seems
arbitrary,
but
at
the
same
time
that
would
mean
there
will
be
four
instead
of
three
mcos
in
in
in
10
care
and
well
yeah.
I
think
maybe
it's
reasonable
in
the
sense
that
we
don't
want
to
crowd
it
with
the
number
of
mcos
either
yeah.
But
those
are
my
thoughts.
E
A
A
A
A
All
right,
if,
if
representative
sparks,
is,
is
listening,
I
will
I
will
roll
his
bill
to
the
heel
of
the
calendar
today
and
otherwise
what
action
may
occur
on
other
bills
if,
if
members
are
not
present
to
present
the
chair
has
the
latitude
to
take
those
bills
off
notice
if
they
do
not
arrive
to
have
those
bills
discussed.
So
without
objection
house
bill
2456
has
rolled
to
the
heel
of
today's
calendar.
A
F
You,
mr
chairman
committee
members
last
week,
I
was
here
presenting
this
bill
on
behalf
of
senator
lamar
and
it
is
the
bill
that
creates
a
pilot
program
within
tenncare
for
remote,
patient
monitoring
and
the
posture
we
were
in.
I
was
trying
to
adopt
an
amendment
and
tenncare
has
input
that
they
wanted
to
give
which
we
met
with
them,
and
we
have
the
amended
language
for
to
satisfy
tenncare.
We
changed
it
from
medically.
F
A
Lady
camper,
do
you
have
the
the
code
on
that
particular
amendment
for
us?
I.
F
A
A
We
have
a
motion
and
a
second
to
consider
the
amendment,
all
those
in
favor
of
consideration
of
amendment
drafting
code,
zero,
one,
five,
seven,
nine
six,
please
signify
by
saying
aye
any
opposed.
Please
say!
No,
all
right!
We
are
considering
your
amendment
and
you
gave
us
a
brief
description.
Is
that,
ultimately,
what
the
amendment
would
do?
Lady
camper.
F
Yes,
sir,
and
thank
you
members
for
agreeing
for
to
help
me
with
this
untimely
amendment.
I
really
appreciate
it,
but
yes,
that's,
that's
all
is
changing
we're,
making
it
medically
necessary
versus
what
we
had
before,
which
was.
A
Yes!
Do
I
hear
a
motion
in
a
second
to
adopt
the
amendment.
We
have
a
motion.
We
have
a
second
all,
those
in
favor
of
adoption
of
amendment
once
again
drafting
code,
zero,
one,
five,
seven,
nine,
six,
please
signify
by
saying
aye
any
opposed.
Please
say
no,
the
eyes
have
it.
Your
amendment
is
adopted.
Lady
camper.
F
Okay,
thank
you,
members
for
adopting
an
amendment.
This
bill
would
give
us
an
opportunity
to
help
mothers
that's
having
a
problem
with
pregnancy,
whether
it's
due
to
some
health
concerns
health
risks
like
diabetes,
precampsia.
This
will
give
them
opportunity
to
be
monitored.
A
A
Just
a
few
comments
again,
I
I
tend
to
put
my
finance
committee
hat
on
whenever
I
come
into
to
this
committee,
and
I
know
several
folks
serve
as
yourself
as
well
serve
on
the
finance
committee
and
as
we're
still
working
on
the
fiscal
note.
I
think
that
policy-wise,
I
think
we
all
see
exactly
where
you're
coming
from
financially
we'll
we'll
have
to
see
how
this
fits
into
the
budget
document,
but
certainly
thank
you
for
for
bringing
the
idea
forward.
F
Oh
thank
thank
you,
mr
chair.
I
just
want
to
thank
you
f
for
that.
I
think
once
we
get
the
new
fiscal
note
to
go
with
this,
we
will
see
that
the
numbers
were
dropped.
F
We
would
we,
the
numbers
will
drop
and
what
I
also
don't
think
is
reflected
in
the
fiscal
note
is
if
we
can
preclude
mothers
from
having
to
have
these
emergency
c-sections,
that
will
save
us
money
and
I
don't
think
that's
really
been
factored
in,
but
it
might
be
as
to
be
a
move
forward
with
fissile
as
I'm
trying
to
work
through
it.
Thank
you,
mr
chairman.
B
A
F
I
think
it
does,
but
what
the
monitoring
would
do
would
I
think,
what
better
help
to
notify
so
that
if
the
mother
is
in
a
situat,
is
in
a
situation
and
don't
realize
it's
happening
by
the
time
they
get
there.
It's
an
emergency
situation.
So
what
this
pilot
would
do
would
give
tenncare
opportunity
to
monitor.
F
Have
these
women
to
be
monitored
so
as
soon
as
they
see
that,
if
something's
going
wrong,
then
they
can
get
the
help
and
they
don't
end
up
in
emergency
room,
that's
kind
of
been
the
problem
and
it's
costing
10
care
more.
Actually
if
they
are
looked
at,
if
they
are
serviced
in
the
emergency
room
versus
going
to
a
doctor
when
they
see
it
onset
of
a
problem,
that's
what
we're
trying
to
preclude
all.
B
A
A
A
We
have
a
second,
you
are
recognizing.
A
Yes,
sir,
we've
got,
and
this
is
a
situation,
ladies
and
gentlemen,
another
untimely
filed
amendment
that
we
will
potentially
need
to
consider
drafting
code,
sir,
that
I
have
I've
got
two
different
ones
tell
me
which
one
you're
looking
for.
I.
A
Zero
one
five,
eight,
nine,
four
okay,
I've
got
a
I've,
got
a
fiscal
note
on
zero
one.
Five,
six,
six,
two
hang
on
just
a
moment.
A
I
understand
that
that
makes
sense,
as
described
to
me,
leader,
love
the
the
the
amendment
code
number
that
you
signified
zero
one.
Five,
eight
nine
four
is
the
one
that
we
would
like
to
move
forward
with.
Yes,.
A
A
A
B
Thank
you,
mr
chairman,
and
the
amendment
makes
the
bill.
The
amendment
deals
with
the
bill
deals
with
doulas
doulas
are
non-medical
professionals
who
provide
emotional
and
physical
assistance
in
different
aspects
of
reproductive
health
and
provide
emotional
support
to
mothers
when
they're
in
the
process
of
childbirth,
and
so
this
particular
amendment
would
have
the
department
of
health
to
collaborate
with
the
bureau
of
tenncare
to
study
existing
doula
certification
programs.
A
Okay,
you
have
heard
the
explanation
of
the
amendment.
We
have
a
motion
to
adopt
the
amendment
we
have
a
second
before
we
take
a
vote
up
just
to
get
some
clarity,
and
I
believe
I
heard
that
this
is
a
study
by
10
carrots
to
look
into
that
we're
not
looking
to
create
an
automatic
certification
of
doulas.
This
is
a
study
to
to
work
on
the
process.
B
That's
correct
and
let
me
also
give
credit
to
now
senator
lamar,
who
was
the
sponsor
this
legislation
and
we've
been
a
long
process
getting
to
this
place.
Actually
this
weekend
had
a
good
conversation
with
both
the
senate
sponsors,
senator
massey
and
people
from
health
and
free
tennessee
and
from
department
of
health
collaborate
and
try
to
figure
out,
what's
the
best
language
to
try
to
get
to
this
place.
A
We
have
a
motion
in
a
second
on
amendment
coded
zero,
one,
five,
eight,
nine,
four,
all
those
in
favor
placing
the
amendment
on
the
bill.
Please
signify
by
saying
aye
any
of
those
opposed.
Please
say
no,
the
eyes
have
it.
Amendment
is
on
your
bill.
I
think
you've
done
a
very
good
job
of
describing
it
any
questions
or
comments
for
our
sponsor.
E
You,
mr
chairman,
thank
you
for
bringing
this
leader
love
just
as
an
observation.
This
is
doulas
are
basically
coaches
or
life
coaches
through
pregnancy
and
postpartum
in
early
childhood,
especially
for
young
women
first
pregnancy.
These
are
very,
very
useful.
Resources
used
to
be
that
grandmothers
and
mothers
took
care
of
this
function,
but
as
the
fabric
for
society
is
not
that
tight
anymore,
this
becomes
a
necessity
but
yeah.
I
think
it
becomes
a
necessity
it
and
it
will
be
good
to
have
it.
That's
how
I
read
it
and
thank
you
for
doing
it.
B
Sir,
just
thank
the
committee
and
again
thank
all
those
who
work
to
get
us
to
this
place.
A
All
right
committee:
are
you
ready
to
vote
all
those
in
favor
of
sending
house
bill
2109
as
amended
the
full
insurance
committee,
please
signify
by
saying
aye
aye
any
of
those
opposed.
Please
say:
no,
the
ice
habits
you
build
most
fuller.
Thank
you,
mr
chairman
committee
members.
Thank
you
very
much.
A
A
A
A
Okay,
that
is
correct.
We
have
a
motion
and
a
second
on
amendment
number
one:
let's
go
ahead
and
put
the
amendment
on
the
bill,
ladies
and
gentlemen,
and
then
we'll
hear
the
explanation
when
we
get
there
all
those
in
favor
of
placing
a
mimiko
zero
three
on
the
bill,
please
signify
by
saying
aye
any
of
those
opposed.
Please
say
no,
the
eyes
have
it.
The
amendment
is
on
your
bill.
Please
describe
your
bill
for
us
as
amended.
Well,.
B
It's
a
reference-based
pricing
bill.
We,
I
don't
know
if
members
remember
we
had
a
summer
study
about.
I
believe
it
was
two
years
ago.
It's
a
complicated
issue.
It
really
is
former
representative
martin
daniel,
had
latched
on
to
this
and
really
started
digging
deep
and
if
you
all
remember,
martin
he's
kind
of
a
pit
bull
when
it
comes
to
cost
and
tackling
issues
he
couldn't
be
here
to
testify.
Today
he
can
be
up
here.
He
thought
he
could
be
up
here
next
next
week,
but
I
thought
y'all
are.
B
Is
this
your
last
calendar,
and
so
we
want
to
get
it.
It's
simply
asking
for
taskr
to
take
this
up
on
studying
reference-based
pricing
montana
took
this
up
and
went
with
this
with
their
employee.
Healthcare
plan
saved
13.6
million-
and
I
know
montana-
is
not
a
great
comparison
of
a
state
they're
much
much
smaller
than
us,
but
they
did
have
some
significant
savings.
North
carolina
also
looked
at
this
and
and
it's
tested
saved
some
money
as
well.
B
When
we
started
looking
at
the
health
care
plan,
there
was
a
lot
of
discrepancies.
There
ralph
webber
who's
wrote
several
books
on
on
on
health
care,
and
improving
transparency
has
really
dug
into
this,
and
what
he's
saying
we
could
save
anywhere
from
70
to
90
million
dollars
if
we
shifted
to
reference
based
pricing.
So
that's
all
I'm
asking
for
is
a
simple
study
and
to
just
improve.
I
think
it
would
improve
transparency.
I
think
it
would
help
us
to
just
dig
down
on
our
health
care
costs.
B
B
A
A
A
A
Have
a
motion:
we
have
a
second,
let's
go
ahead
and
get
into
the
proper
posture.
We'll
put
the
amendment
on
all
those
in
favor
of
adding
amendment
code,
zero,
one,
four,
seven,
seven!
Six
to
the
bill,
please
signify
by
saying
aye
any
of
those
posts.
Please
say
no,
the
eyes!
Have
it!
Lady
rutter!
Please
explain
your
bill
as
amended.
B
Thank
you,
mr
chairman
and
committee.
This
bill
has
to
do
with
our
copay
commun
accumulator
bill
that
we
passed
out
of
this
committee
last
year
and
what
I'm
I'm
still
working
with
both
sides
on
this,
and
so
I
would
like
to
move
this
onto
full
committee,
so
I
can
continue
to
have
those
discussions
and
with
that
I
ask
your
indulgence
and
let
me
move
this
on
to
full
committee
with
this
bill
you
know,
may
not.
We
may
not
need
to
continue
those
discussions,
but
I
would
like
to
have
that
opportunity.
A
Thank
you,
chair
lady
rutter,
and
I
think
there's
some
votes
going
on
in
the
senate.
Right
now,
as
well.
At
least
the
meeting
is
beginning
in
the
senate
right
now
that
could
have
some
bearing
on
on
this,
but
much
as
as
chairman
kumar
has
allowed
us
to
move
some
bills
from
this
subcommittee
to
full,
with
the
idea
of
seeing
what
may
happen
in
the
senate
or
or
working
on
amendments
again.
The
chair
feels
comfortable
in
doing
so
any
questions
or
comments
of
the
sponsor
of
the
legislation.
A
All
right
question
has
been
called.
We
are
on
the
bill,
all
those
in
favor
of
sending
house
bill
2879
to
full
insurance
committee.
Please
signify
by
saying
aye
any
opposed.
Please
say
no,
if
you'd
like
to
say,
if
you'd
like
to
vote.
No,
please
let
the
clerk
know
the
bill
passes
house
bill.
2879
goes
to
full
committee.
E
Okay,
we
are
considering
item
number
10
house
bill:
zero,
zero,
two
by
by
chairman,
hawk
chairman,
hawk
you're,
recognized.
A
That
that
that
essentially
codifies
what's
what
has
just
recently
been
passed
by
federal
law,
we're
in
a
wait-and-see
mode
on
this
particular
piece
of
legislation,
I
think
there's
many
factors
that
are
swirling
about
now.
E
A
A
All
right,
ladies
and
gentlemen,
before
we
before
we
move
forward,
I
do
want
to
take
a
little
privilege
from
the
chair.
I
want
to
thank
everyone
for
the
diligent
work
that
you
have
provided
this
subcommittee
this
year.
We
may
or
may
not
get
called
back
in
depending
on
what
the
situation
is.
I
thank
you
for
your
attendance.
Thank
you
for
your
diligence.
You've
done
some
tremendous
work
and
I
appreciate
you
more
than
you
ever
know.
Chairman
sipiki,
you
are
recognized.