House Bill 863

AN ACT TO ESTABLISH THE "DESOTO PLAN FOR HEALTH CARE SERVICES ACT OF 2003"; TO PROVIDE THAT THE PLAN SHALL PROVIDE HEALTH CARE SERVICES TO WORKING LOW INCOME INDIVIDUALS ON A PREPAID BASIS; TO PROVIDE ELIGIBILITY REQUIREMENTS; TO PROVIDE THAT THE PLAN SHALL BE OPERATED ON A NOT-FOR-PROFIT BASIS; TO PROVIDE THAT HEALTH SERVICES SHALL BE RENDERED FOR NOMINAL REIMBURSEMENT ON A SLIDING SCALE; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. This act shall be known and may be cited as the "DeSoto Plan for Health Care Services Act of 2003."

SECTION 2. The Legislature finds that there is a problem with availability and affordability of health care services for working lower income persons. It is the intent of this Legislature to make such coverage more available and affordable by authorizing the development of innovative plans to prepay such coverage.

SECTION 3. (1) The DeSoto Plan for Health Care Services is a plan which provides health care services to working low income individuals on a prepaid basis and such plan shall not be deemed to be insurance or a service plan or corporation or health maintenance organization within the provisions of Section 83-1-1, et seq.

(2) Eligibility for enrollment in the plan is limited to persons employed in businesses employing fifty (50) eligible persons or less and persons engaged in domestic service in private households and dependents of such persons where such persons earn less than two hundred percent (200%) of the federal poverty level and are not covered under any other group insurance arrangements. Employers employing fifty (50) eligible persons or less may prepay the clinic or health center for health services for the benefit of their employees.

(3) The plan is operated on a not-for-profit basis under the sponsorship of a not-for-profit organization.

(4) Covered primary care services under the plan are provided to enrollees in the plan either by providers on staff of the sponsoring organization or by volunteers who, in both instances, have agreed to provide their services for a nominal reimbursement on a sliding scale according to the income of the enrollee for out-of-pocket expenses or expendable supplies, or both, directly related to and incurred as a result of the service provided to the enrollee.

(5) Payments to outside contractors under the plan for marketing, claims, administration and similar services shall total no more than ten percent (10%) of the total charges.

(6) Except as provided in subsection (4) of this section, no portion of any fees or charges under the plan shall be paid directly or indirectly as salary to any officer or director of the sponsoring not-for-profit organization.

SECTION 4. This act shall take effect and be in force from and after July 1, 2003.