20-182. Factors for assessing impact;
certification of report


A. To the extent that information is available, the report prescribed by section
20-181 shall include, but not be limited to, the following:


1. The social impact:


(a) The extent to which the treatment or service is generally utilized by a
significant portion of the population.


(b) The extent to which the insurance coverage is already generally available.


(c) If coverage is not generally available, the extent to which the lack of
coverage results in persons avoiding necessary health care treatments.


(d) If the coverage is not generally available, the extent to which the lack of
coverage results in unreasonable financial hardship to a patient.


(e) The level of public demand for the treatment or service.


(f) The level of public demand for insurance coverage of the treatment or service.


(g) The level of interest of collective bargaining agents in negotiating privately
for inclusion of this coverage in group contracts.


2. The financial impact:


(a) The extent to which the coverage will increase or decrease the cost of the
treatment or service.


(b) The extent to which the coverage will increase the appropriate use of the
treatment or service.


(c) The extent to which the mandated treatment or service will be a substitute for
a more expensive treatment or service.


(d) The extent to which the coverage will increase or decrease the administrative
expenses of insurers and the premium and administrative expenses of policyholders.


(e) The impact of this coverage on the total cost of health care.


B. An actuary who is a member of the American academy of actuaries shall prepare
the financial impact analysis required by subsection A, paragraph 2 of this section and
certify that the analysis is consistent with accepted actuarial techniques.


C. The report required by section 20-181 shall address the specific language of the
proposed mandate. A report on a similar proposal in a different jurisdiction is
insufficient and does not meet the requirements of section 20-181.


D. An organization, individual or legislator that does not submit a report required
by section 20-181 is not subject to any civil sanction or criminal penalty.