AS TABLED IN THE HOUSE OF ASSEMBLY

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1 AS TABLED IN THE HOUSE OF ASSEMBLY A BILL entitled HEALTH INSURANCE (MISCELLANEOUS) AMENDMENT ACT 2015 TABLE OF CONTENTS Citation Amends section 2 of Health Insurance Act 1970 Amends section 3A of Health Insurance Act 1970 Amends section 26 of Health Insurance Act 1970 Amends Health Insurance (Standard Hospital Benefit) Regulations 1971 Amends Health Insurance (Mutual Re-Insurance Fund) (Prescribed Sum) Order 2014 Amends Health Insurance (Artificial Limbs and Appliances) Regulations 1971 Amends Health Insurance (Approved Scheme) Regulations 1971 General amendment of Acts General amendment of statutory instruments WHEREAS it is expedient to amend the Health Insurance Act 1970 and various statutory instruments made pursuant to that Act, and to make general amendments to effect the renaming of the standard hospital benefit as the standard health benefit ; Be it enacted by The Queen s Most Excellent Majesty, by and with the advice and consent of the Senate and the House of Assembly of Bermuda, and by the authority of the same, as follows: Citation 1 This Act may be cited as the Health Insurance (Miscellaneous) Amendment Act Amends section 2 of Health Insurance Act Section 2 of the Health Insurance Act 1970 is amended in the heading, by deleting hospital treatment of ; in subsection (1) by after paid to the Board inserting (and to an approved health care provider) ; and 1

2 (e) in paragraphs, and (bb) by, in each case, after general hospital inserting or from an approved health care provider (as the case may be) ; in paragraph, by deleting hospital treatment received by that person as may be agreed between the Minister and the Board and substituting hospital treatment (or health care provided by an approved health care provider) received by that person as may be agreed between the Minister and the Board or, in respect of an approved health care provider, the Committee ; in subsection (3), by after hospital treatment, both times it appears, inserting (or health care provided by an approved health care provider) ; in subsection (5), by after paid inserting to the Board ; and by inserting after subsection (6) (7) In this section, approved health care provider means a residential care home or nursing home within the meaning of the Residential Care Homes and Nursing Homes Act 1999; a person providing hospice care; or a person providing post-acute care at the patient s, or a caregiver s, home, that is approved in writing by the Committee and qualifies under subsection (8) for payment of the subsidy referred in subsection (1). (8) To qualify for the payment of subsidy, the health care provider must provide such health care as is approved by the Committee, to a person, and at such fees, as are approved by the Committee.. Amends section 3A of Health Insurance Act Section 3A of the Health Insurance Act 1970 is amended in subsection (2A) in paragraph, by deleting or ; and in paragraph, by deleting the comma and substituting ; or ; and by inserting after paragraph the Board, ; and by inserting after subsection (2B) (2C) The Committee may 2

3 establish and supervise a primary care programme for the treatment of chronic, noncommunicable diseases; and determine the programme s eligibility criteria and benefits, and there shall be paid out of the Mutual Re-Insurance Fund claims, approved by the Committee, in respect of the programme.. Amends section 26 of Health Insurance Act Section 26 of the Health Insurance Act 1970 is amended in subsection (1) by deleting An employer and substituting Subject to subsection (5), an employer ; in subsection (2) by deleting who proposes and substituting with an approved scheme who wishes to continue ; by, after approved scheme shall, inserting annually, in the prescribed form with the prescribed fee, ; by deleting proposed both times it appears; and by deleting give its approval thereto and substituting renew its approval of the scheme ; in subsection (3) by deleting approve any proposed scheme and substituting renew its approval of a scheme ; and by inserting after subsection (4) (5) After the coming into operation of the Health Insurance (Miscellaneous) Amendment Act 2015, the Council shall not approve any new (proposed) scheme, but may renew its approval of an existing approved scheme.. Amends Health Insurance (Standard Hospital Benefit) Regulations The Health Insurance (Standard Hospital Benefit) Regulations 1971 are amended in the title and generally throughout the text by deleting standard hospital benefit and substituting standard health benefit ; in regulation 3 in paragraph, by deleting necessary for the initial treatment of accidental injuries suffered within forty-eight hours preceding the time of treatment or of acute illness ; in paragraph (vi), by deleting Health Insurance ; and in paragraph (xiv)(bb), by deleting Health Insurance ; in regulation 5 by inserting after paragraph (vii) 3

4 (e) (f) (g) (viia) screening mammograms that do not adhere to Recommendations A or B of the United States Preventive Services Task Force (USPSTF) Guidelines, unless there is a referral from a registered medical practitioner; ; in regulation 9 by deleting $ and substituting $ ; deleting $69.66 and substituting $78.02 ; deleting $29.18 and substituting $63.74 ; and deleting $6.73 and substituting $14.71 ; in regulation 10 by deleting $1, and substituting $1, ; deleting $ and substituting $ ; deleting $29.18 and substituting $63.74 ; and deleting $6.73 and substituting $14.71 ; in regulation 11 in paragraph (1), by deleting $ and substituting $ ; in paragraph (1), by deleting $34.83 and substituting $39.01 ; in paragraph (1), by deleting $ and substituting $ ; and in paragraph (1), by deleting $ and substituting $ ; and in regulation 12 in paragraph (1), by deleting $34.83 and substituting $39.01 ; and in paragraph (1), by deleting $ and substituting $ Amends Health Insurance (Mutual Re-Insurance Fund) (Prescribed Sum) Order Paragraph 2 of the Health Insurance (Mutual Re-Insurance Fund) (Prescribed Sum) Order 2014 is amended in paragraph, by deleting $14.00 and substituting $18.40 ; in paragraph, by deleting and ; in paragraph, by deleting $0.67 per month. and substituting $1.00 per month; and ; and by inserting after paragraph to the Board, the sum of $23.64 per month.. 4

5 Amends Health Insurance (Artificial Limbs and Appliances) Regulations Regulation 3(2) of the Health Insurance (Artificial Limbs and Appliances) Regulations 1971 is amended by deleting $15,000 both times it occurs and, each time, substituting 30,000. Amends Health Insurance (Approved Scheme) Regulations The Health Insurance (Approved Scheme) Regulations 1971 are amended in regulation 2(2), by deleting approve a proposed and substituting renew approval of a ; in regulation 3, by deleting grant or and proposed ; and in the Schedule General amendment of Acts 9 The following Acts in the first line, by deleting Proposed ; by deleting paragraph 1 of the Notes; and in paragraph 2(f) of the Notes, after surety, by inserting, required by section 26(3) of the Act,. Bermuda Hospitals Board Act 1970; Government Employees (Health Insurance) Act 1986; and Health Insurance Act 1970, are amended generally throughout the text by deleting standard hospital benefit or standard hospital benefits and, in each case, substituting standard health benefit. General amendment of statutory instruments 10 The following statutory instruments (e) (f) (g) (h) Bermuda Hospitals Board (Hospital Fees) Regulations 2014; Government Employees (Health Insurance) (Benefits) Order 1997; Government Employees (Health Insurance) (Rates) Order 2001; Health Insurance (Approved Scheme) Regulations 1971; Health Insurance (Artificial Limbs and Appliances) Regulations 1971; Health Insurance (Double Cover) Regulations 1971; Health Insurance (Exemption) Regulations 1971; Health Insurance (Licensing of Insurers) Regulations 1971; Health Insurance (Mental Illness, Alcohol and Drug Abuse) Regulations 1973; and 5

6 (j) Health Insurance (Plans) Regulations 1987, are amended generally throughout the text by deleting standard hospital benefit and substituting standard health benefit. 6

7 HEALTH INSURANCE (MISCELLANEOUS) AMENDMENT BILL 2015 EXPLANATORY MEMORANDUM This Bill seeks to amend the Health Insurance Act 1970 and various statutory instruments made pursuant to that Act, and to make general amendments to effect the renaming of the standard hospital benefit as the standard health benefit. Clause 1 is self-explanatory. Clause 2 amends section 2 of the Health Insurance Act Currently, section 2 limits subsidy coverage to services provided by the Bermuda Hospitals Board. The amendments allow subsidy payments also to be made in certain circumstances to health care providers approved by the Health Insurance Committee. This would allow flexibility for subsidy funds to be used to pay for services in clinically appropriate, lower cost settings than the general hospital such as in residential care or nursing homes or in a patient s home. Clause 3 amends section 3A of the Health Insurance Act 1970 by inserting a new subsection (2C). This new subsection allows the Committee to establish and supervise a primary care programme for the treatment of chronic, noncommunicable diseases, and provides that claims shall be paid out of the Mutual Re-insurance Fund. Clause 4 amends section 26 of the Health Insurance Act 1970 to provide that whilst existing approved schemes may continue to be approved on an annual basis, no new schemes will be approved. Clause 5 amends the Health Insurance (Standard Hospital Benefit) Regulations 1971 to increase the standard premiums and deductions as set out. Regulation 3 is amended to clarify that outpatient surgery provided at the general hospital is covered by the standard health benefit and, in regulation 5, a new exemption is added for screening mammograms that do not adhere to Recommendations A and B of the United States Preventive Services Task Force Guidelines. Clause 6 amends the Health Insurance (Mutual Re-Insurance Fund) (Prescribed Sum) Order 2014 to increase payments made out of the Mutual Reinsurance Fund as set out. Clause 7 amends Health Insurance (Artificial Limbs and Appliances) Regulations 1971 to increase the maximum liability for an artificial limb or appliance from $15,000 to $30,000. Clause 8 amends the Health Insurance (Approved Scheme) Regulations 1971 in consequence of the amendment of section 26 of the Health Insurance Act 1971 in clause 4. Clause 9 amends the specified Acts to change all references to standard hospital benefit to the new terminology standard health benefit. Clause 10 amends the specified statutory instruments to change all references to standard hospital benefit to the new terminology standard health benefit. i