Wyoming

SUMMARY

Wyoming was one of the first states to enact a law to allow out-of-state regulated insurers to sell insurance products domestically, in an attempt to increase competition and decrease the cost of entering the new market. Although Wyoming has made limited strides in health care cost transparency, the Wyoming Hospital Association has attempted to fill in the gap by offering a price disclosure database for its hospitals online. A coalition of Wyoming employers is also interested in obtaining charge data across all insured in order to better negotiate rates directly with providers.

 

LEGISLATION/REGULATION

Legislative Calendar

Wyoming’s current regular legislative runs from 2/12/2018 – 3/15/2018.

Recent Legislative Developments

Healthcare Transparency

2018 HB 124 

 

HEALTH CARE TRANSPARENCY ACT: Requiring any health care provider to disclose the health care plans in which the provider participates and additional information about providers and services as specified. If a health care provider does not participate in the network of a patient’s or prospective patient’s health care plan, the health care provider shall: before providing nonemergency services, inform a patient that the amount or estimated amount the health care provider will bill the patient for health care services is available upon request. Upon receipt of a request from a patient, disclose to the patient in writing the amount or estimated amount or a schedule of fees that the health care provider will bill the patient for health care services provided to the patient absent unforeseen medical circumstances that may arise. Inactive – Failed introduction.
HB 107 PHARMACY BENEFIT MANAGERS – PROHIBITED PRACTICES: Would prohibit insurers and pharmacy benefit managers from penalizing pharmacy or pharmacist for disclosing to the consumer information about the cost of the prescription drug and availability of therapeutically equivalent alternative medicine or alternative methods of purchasing the prescription drug. Would insurance drug out of pocket costs to the lesser of: the insurance benefit cost sharing, the amount the insurer or pharmacy benefit manager will reimburse the pharmacy for the dispensed drug or the price that would be charged in the absence of any insurance coverage (the cash price). Inactive – Failed introduction.


Healthcare Cost

  • None identified.

 

Healthcare Markets

2018 SF 09

 

HEALTH INSURANCE MARKETS: Allows foreign insurers to seek authority to write lines of insurance if, in the commissioner’s opinion adequate provisions do not already exist within state markets, or adequate competition does not exist between insurers that exist within the state. Passed – Approved by House and Senate on 3/6/2018; submitted to Governor.
SF 75 PRESCRIPTION DRUGS AUTHORIZATION OF INTERCHANGEABLE BIOLOGICAL PRODUCTS: Would permit a pharmacist to substitute an interchangeable biological for the prescribed original biologic product or substitute the generic equivalent of a prescribed pharmaceutical, unless the prescriber has clearly indicated substitution is not permitted. Would require a pharmacist, upon dispensing an interchangeable biological product or generic equivalent drug, to label the prescription container with the name of the dispensed biological product or drug. Passed – signed by Governor 3/16/2018. Chapter No. 93 Session Laws of Wyoming 2018
SF 88 HEALTH CARE REFORM: Creating a multi-payer health claims database; creating a prescription drug importation program; creating a Medicaid buy-in program; creating a Medicaid prescription drug program for insurers; providing that specified interest rates relating to health care charges and debts are unlawful; requiring the submission of a waiver application relating to the Medicaid buy-in program; requiring specified actions relating to the expansion of Medicaid and the child health insurance program; requiring specified actions relating to telemedicine. Inactive – Failed introduction.
SJ 05 A JOINT RESOLUTION requesting Congress and Wyoming’s Congressional delegation to endorse use of health savings accounts and reinsurance programs to promote individual choice in health care; to support federal legislation lifting impediments and endowing states with authority to establish health care cost and saving mechanisms; to encourage application for a state innovation waiver of Patient Protection and Affordable Care Act requirements; and to promote health care billing transparency protocols. Passed – Approved by Senate and House.


Key Statutes

Healthcare Markets

  • Stat. Ann. § 26-18-201 through 208 directs the insurance commissioner to identify five states with insurance laws similar to Wyoming for the purpose of creating a “multi-state consortium with reciprocity agreements for [the] approval, offer, sale, rating, including medical underwriting, renewal and issuance of individual medical and surgical health insurance policies.” The legislature expects that by combining the population of several states under one regulator, insurance companies will be able to introduce lower cost products to residents.

 

  • Stat. Ann. 26-18-301 through 307 mandates that the insurance commissioner shall approve for sale in Wyoming any individual or small employer health insurance policy or high deductible plan that is currently approved for issuance in another state provided that the insurance company subjects itself to Wyoming’s regulatory authority and conforms with the strictures of that article. Presumptively, this act will increase the number of options available to Wyoming consumers.

 

 

  • Stat. Ann. § 26-34-134 regarding Health Maintenance Organizations, requires that a provider willing to meet the established terms and conditions required of any provider interested in entering into an agreement to furnish healthcare services to enrollees in the HMO cannot be excluded. The terms and conditions cannot discriminate against a provider on the basis of an inability to provide specified health services within the entire HMO service area.

 

  • Stat. Ann. § 26-43-113 Wyoming operates a high risk pool called the Wyoming Health Insurance Pool to provide health insurance to residents who are denied health insurance. The Pool is statutorily slated to terminate on June 30, 2015. Premium rates for the high risk pool are frozen pursuant to SB 84, enacted & signed by the governor as Chapter No. 113, 3/1/2013, for the period beginning July 1, 2013 through June 30, 2015.

 

LITIGATION/ENFORCEMENT 

  • None identified.

 

KEY RESOURCES

Wyoming State Legislature

Wyoming Office of the Attorney General

Wyoming Department of Insurance