Senate Bill Closes HIPAA Coverage Loophole

November 5, 2003 (PLANSPONSOR.com) - A measure which passed a United State Senate committee Wednesday closes a potential loophole in a 1996 insurance anti-discrimination law allowing health plans to deny insurance payments for injuries suffered while involved in certain recreational activities.

The Senate Health, Education, Labor and Pensions Committee approved the Health Care Parity for Legal Transportation and Recreational Activities Act by voice vote, according to a Reuters report.

The bill would amend HIPAA which, among other things, bars health plans from excluding from group coverage or charging higher premiums to individuals who participate in a range of activities, including “motorcycling, snowmobiling, all-terrain vehicle riding, horseback riding, skiing, and other similar activities.” Regulations to implement the law issued in 2001, however, said that while the law prevents individuals in group health plans from being excluded from coverage or charged higher premiums, “benefits for a particular injury can, in some cases, be excluded based on the source of the injury.”

Under the bill, backers of the latest loophole-closing meaure feared, those undertaking potentially dangerous activities have to have access to insurance but insurers would not necessarily have to cover injuries resulting from those activities.

The bill’s lead cosponsor, Senator Russell Feingold (D-Wisconsin), whose state is home to motorcycle maker Harley Davidson, asserted, “millions of Americans rely on motorcycles for their transportation to work. Individuals should not be singled out just because they choose a different mode of transportation to go to work.”

The bill would stipulate that benefits might not be denied for an injury “solely because such injury resulted from participation of the participant or beneficiary in an activity such as motorcycling, snowmobiling, all-terrain vehicle riding, horseback riding, skiing, or other similar legal activity.”

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