Medically Necessary Elective Surgery Act (660)

PASSED by the General Assembly on 22 November 661 - 12 Aye, 4 Nay, 5 Abstain
A bill to mandate the coverage of medical elective surgery by insurance providers.

Article I - Definitions

1.1 The Ministry of Health and Education will establish a commission to establish and define specific necessary elective surgery procedures.

1.1.1 Necessary elective surgery is defined by any surgery that is not an emergency surgery, but is required to alleviate any medical condition with serious or life-altering impacts.

1.1.2 The established commission must review all items on the list of elective surgery at least once per year. The commission may add or remove items from this list at any time.

1.2 Medical insurance is defined as any benefits consisting of medical care, provided directly, through insurance or reimbursement, or otherwise and including items and services paid for as medical care provided by any hospital or healthcare provider.

Article II - Mandated Coverage of Elective Surgery

2.1 Medical insurance shall be required to cover all medical elective surgery as defined by the Ministry of Health and Education. This coverage shall be no less than eighty percent of the final cost of all associated costs of surgery, including specialist consultation, anesthesia, and any pre- and post-operative care.

2.2 The Ministry of Health and Education will ensure that all medical insurance providers comply with this legislation. The Ministry of Health and Education may issue fines and other punishments to any medical insurance provider that is found to be out of compliance with this legislation.

Article III - Funding

3.1 The Ministry of Health and Education will be granted 5 million florins per quarter for the funding of the commission and the per diem payment of expert witnesses and advisors.

Tabled by Braughn F.G. Kryos, MGA.