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Charlotte Amalie
Sunday, August 14, 2022
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Senate Looks at Direct Insurance Payments to Providers

V.I. medical and dental insurance policies will have to allow for payment directly to providers – and cover services for autism spectrum disorders – if two bills approved by the Health, Hospitals, Human Services and Veterans’ Affairs Committee are enacted into law.

One bill, [Bill 30-0253] sponsored by Sen. Craig Barshinger, would require insurance companies to allow patients to assign payment directly to doctors, dentists and other health care providers.

Mary “Pixie” Enloe, who works with the dentistry practice of her husband, Dr. Michael Enloe, testified that some insurance companies have resisted or declined to provide direct payment to dentists, which creates a hardship as the practice tries to collect from many patients long after the fact..

"Just imagine 35 percent of your office budget being sent out to 85 of your constituents" and having to go collect it, Enloe told the senators.

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Director of Banking and Insurance John McDonald said his division did not oppose the bill.

Voting to send the bill out of committee for consideration by the Rules and Judiciary Committee were Barshinger, Sens. Tregenza Roach, Sammuel Sanes and Clarence Payne. Absent were Sens. Kenneth Gittens, Alicia "Chucky" Hansen and Terrence "Positive" Nelson.

The other bill, sponsored by Sen. Nereida "Nellie" Rivera-O’Reilly, simply requires health insurers to
provide coverage for the assessment, diagnosis and treatment of autism spectrum disorders.

"Autism is the most common of all serious childhood disorders, affecting 1.5 million Americans," O’Reilly said, introducing the bill. It is four times more common in boys than in girls, she said.

"Early interventions are critical," O’Reilly said. Getting proper help when the child is young makes for better results later in life, she explained.

Human Services Commissioner Chris Finch, doctors, parents of patients on the autism spectrum and others testified about the importance of early intervention in autism and in support of the bill.

Insurance policies generally cover some aspects of autism care, but it varies by policy and is not comprehensive, said Dr. Lindsay Wagner, who specializes in care for children with autism.

Finch said Human Services is working on the best way to provide this coverage through Medicaid. Of several possible approaches, it may be easiest to use Medicaid funding for autism services by beefing up Human Services’ own direct services, he said. But the department’s approach "is a work in progress,” he said.

Voting to send the measure on for further consideration were Barshinger, Roach, Sanes, Payne and Nelson. Absent were Gittens and Hansen.

The committee heard testimony on two other bills but held them in committee for amendment. One sponsored by Sanes would allow pharmacists, who have been properly trained and certified, to administer vaccinations. There was no opposition and testifiers from the Health Department, the V.I. Board of Medical Examiners, V.I. Pharmacy Board, a regional pharmacy supervisor for Walgreens and others all testified in support, saying all 50 states have this and it will improve health outcomes in the territory.

Several testifiers suggested changing language setting fees and creating rules be replaced with language giving that power to the V.I. Pharmacy Board and Board of Medical Examiners. Sanes asked for the bill to be held until later this month so amendments can be drafted.

The committee held a bill from Sen. Clifford Graham that overhauls the fees, definitions and laws governing the practice of physical therapy in the territory, due to a lack of a quorum late in the afternoon.

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V.I. medical and dental insurance policies will have to allow for payment directly to providers – and cover services for autism spectrum disorders – if two bills approved by the Health, Hospitals, Human Services and Veterans’ Affairs Committee are enacted into law.

One bill, [Bill 30-0253] sponsored by Sen. Craig Barshinger, would require insurance companies to allow patients to assign payment directly to doctors, dentists and other health care providers.

Mary “Pixie” Enloe, who works with the dentistry practice of her husband, Dr. Michael Enloe, testified that some insurance companies have resisted or declined to provide direct payment to dentists, which creates a hardship as the practice tries to collect from many patients long after the fact..

"Just imagine 35 percent of your office budget being sent out to 85 of your constituents" and having to go collect it, Enloe told the senators.

Director of Banking and Insurance John McDonald said his division did not oppose the bill.

Voting to send the bill out of committee for consideration by the Rules and Judiciary Committee were Barshinger, Sens. Tregenza Roach, Sammuel Sanes and Clarence Payne. Absent were Sens. Kenneth Gittens, Alicia "Chucky" Hansen and Terrence "Positive" Nelson.

The other bill, sponsored by Sen. Nereida "Nellie" Rivera-O'Reilly, simply requires health insurers to
provide coverage for the assessment, diagnosis and treatment of autism spectrum disorders.

"Autism is the most common of all serious childhood disorders, affecting 1.5 million Americans," O'Reilly said, introducing the bill. It is four times more common in boys than in girls, she said.

"Early interventions are critical," O'Reilly said. Getting proper help when the child is young makes for better results later in life, she explained.

Human Services Commissioner Chris Finch, doctors, parents of patients on the autism spectrum and others testified about the importance of early intervention in autism and in support of the bill.

Insurance policies generally cover some aspects of autism care, but it varies by policy and is not comprehensive, said Dr. Lindsay Wagner, who specializes in care for children with autism.

Finch said Human Services is working on the best way to provide this coverage through Medicaid. Of several possible approaches, it may be easiest to use Medicaid funding for autism services by beefing up Human Services' own direct services, he said. But the department's approach "is a work in progress,” he said.

Voting to send the measure on for further consideration were Barshinger, Roach, Sanes, Payne and Nelson. Absent were Gittens and Hansen.

The committee heard testimony on two other bills but held them in committee for amendment. One sponsored by Sanes would allow pharmacists, who have been properly trained and certified, to administer vaccinations. There was no opposition and testifiers from the Health Department, the V.I. Board of Medical Examiners, V.I. Pharmacy Board, a regional pharmacy supervisor for Walgreens and others all testified in support, saying all 50 states have this and it will improve health outcomes in the territory.

Several testifiers suggested changing language setting fees and creating rules be replaced with language giving that power to the V.I. Pharmacy Board and Board of Medical Examiners. Sanes asked for the bill to be held until later this month so amendments can be drafted.

The committee held a bill from Sen. Clifford Graham that overhauls the fees, definitions and laws governing the practice of physical therapy in the territory, due to a lack of a quorum late in the afternoon.