HR 1253 Passes United States House of Representatives
MRF NEWS (April 2, 2009) -- The Motorcycle Riders Foundation reports that the US House passed HR 1253, sponsored by Michael C. Burgess (R-TX) and cosponsored by Bart Stupak (D-MI), which would require that people signing up for a health plan receive in writing an explanation of treatment limits or non-covered conditions, along with other plan restrictions, "in a form that is easily understandable." The bill passed with overwhelming support with the final vote coming in at 422-3.
All group health plans would be covered by the bill, and health plans would be required to provide the information before customers sign up.
"We are going to stand up and shine a light on these exclusions so Americans will not be caught off-guard by exclusions buried deep within an insurance plan," said Burgess, a physician.
HR 1253 at this point does not have a Senate companion bill which is the next step before this legislation is signed into law.
"This legislative action keeps Congress on record that this issue needs their attention," said Jeff Hennie, MRF Vice President of Government Relations. "While this bill is a step in the right direction, the MRF remains committed to securing coverage of any injury that comes from legal use of an on-road motorcycle."
HR 1253 Passes Through the House
April 1, 2009 -- On March 31st, H.R.1253 (legislation that would make it illegal for insurance providers to exploit what is known as the "source of injury exclusion" loophole) passed through the House of Representatives on a vote of 422-3. The Bill now moves on to the Senate. More to follow.
MRF: HIPAA Update
MRF NEWS (March 17, 2009) -- On Wednesday, March 4, 2009, The United States House of Representatives Committee on Energy and Commerce passed legislation that would make it illegal for insurance providers to exploit what is known as the "source of injury exclusion" loophole; reports the Motorcycle Riders Foundation.
On that day the committee chaired by US Representative Henry Waxman considered 10 bills that had passed the House with bipartisan support in the 110th Congress. Under a motion those bills were ordered favorably reported to the House by unanimous consent.
Under current law, insurance providers can refuse to pay for treatment of an injury based solely on the source of the injury.
Simply by pointing to the "source of injury" law, no prior notice of possible denial of benefits for that source of injury is required.
Sources of injury that can be used as a reason by insurance providers to refuse payment of medical bills include motorcycling, snow skiing, ATVs and horseback riding.
According to HR 1253, known as the Health Insurance Source of Injury Clarification Act, if an insurance provider wants to be able to put limitations on payment for an injury from a specific source they must meet the following requirements.
- “Make such limitations and restrictions explicit and clear; "
- "If part of a group plan, must be disclosed to plan sponsor in advance of the point of sale of plan;"
- "The plan sponsor and issuer of health insurance coverage provide a description that is easily understandable to the participant prior to enrollment."
To summarize the legalese, your health insurance provider can limit payment for an injury sustained on a motorcycle so long as it is spelled out to you in simple terms well in advance of you joining the plan.
Closing the loophole entirely and mandating that insurance companies must cover all injuries sustained while operating a legal motorcycle is still the ultimate goal of the MRF. HR 1253 puts Congress on record that this issue needs attention and is willing to work on it. The MRF will continue to keep you updated on this important matter.