SB 455-1_ Filed 01/27/2000, 09:23

COMMITTEE REPORT

MR. PRESIDENT:

    The Senate Committee on Health and Provider Services, to which was referred Senate Bill No. 455, has had the same under consideration and begs leave to report the same back to the Senate with the recommendation that said bill be AMENDED as follows:

SOURCE: Page 1, line 1; (00)CR045501.1. -->     Page 1, delete lines 1 through 17, begin a new paragraph and insert:
SOURCE: IC 12-7-2-149.1; (00)CR045501.1. -->     "SECTION 1. IC 12-7-2-149.1 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 149.1. Notwithstanding section 149 of this chapter, "provider", for purposes of IC 12-15-11-4.1 (c), has the meaning set forth in IC 12-15-11-4.1 (a).
    (b) This section expires March 1, 2001.

SOURCE: IC 12-15-11-4.1; (00)CR045501.2. -->     SECTION 2. IC 12-15-11-4.1 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 4.1. (a) As used in subsection (c), "provider" refers to a provider that is the sole disproportionate share hospital in:
        (1) a city having a population of more than one hundred ten thousand (110,000) but less than one hundred twenty thousand (120,000); or
        (2) a city having a population of more than thirty-three thousand eight hundred fifty (33,850) but less than thirty-three thousand nine hundred (33,900).

    (b) Notwithstanding section 4 of this chapter, except as provided in subsection (c), a provider desiring to participate in the Medicaid program by providing physician services as a managed care

provider must enter into a provider agreement with the office or the contractor under IC 12-15-30 to provide Medicaid services.
     (c) A provider must be:
        (1) considered a provider in the Medicaid program;
        (2) included in the list of managed care providers furnished to each recipient in the city in which the provider provides services; and
        (3) allowed by the office or the office's managed care contractor to provide services to each individual who:
            (A) is eligible to receive services under IC 12-15; and
            (B) resides in the same city in which the provider is located;
        if the individual elects to receive services from the provider;
if the provider has in good faith attempted to negotiate the terms of a provider agreement with the office or the contractor under IC 12-15-30 to provide Medicaid services.

    (d) A provider that provides services under subsection (c) must abide by all lawful determinations made by the office's managed care contractor regarding appropriate and medically necessary care.
    (e) This section expires March 1, 2001.

SOURCE: IC 12-15-11-6.1; (00)CR045501.3. -->     SECTION 3. IC 12-15-11-6.1 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 6.1. (a) Notwithstanding section 6 of this chapter, the office may not exclude a provider described in IC 12-15-12-3.1 from participating in the Medicaid program by entering into an exclusive contract with another provider or group of providers, except as provided under section 7 of this chapter.
    (b) This section expires March 1, 2001.

SOURCE: IC 12-15-12-1.1; (00)CR045501.4. -->     SECTION 4. IC 12-15-12-1.1 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 1.1. (a) Notwithstanding section 1 of this chapter, except as provided in sections 6, 7, and 8 of this chapter, a Medicaid recipient may obtain any Medicaid services from a provider described in section 3.1 of this chapter.
    (b) This section expires March 1, 2001.

SOURCE: IC 12-15-12-2.1; (00)CR045501.5. -->     SECTION 5. IC 12-15-12-2.1 IS ADDED TO THE INDIANA

CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 2.1. (a) Notwithstanding section 2 of this chapter, except as provided in sections 8 and 9 of this chapter, a Medicaid recipient may receive health care services from a provider selected by the recipient from a list of managed care providers and other providers:
        (1) furnished to the recipient by the office under section 3.1 of this chapter; or
        (2) otherwise described in IC 12-15-11-4.1 (c).
    (b) This section expires March 1, 2001.

SOURCE: IC 12-15-12-3.1; (00)CR045501.6. -->     SECTION 6. IC 12-15-12-3.1 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 3.1. (a) Notwithstanding section 3 of this chapter, except as provided in section 9 of this chapter, the list of providers furnished to the recipient must include the names of the following:
        (1) All managed care providers that meet the following requirements:
            (A) Have entered into a provider agreement with the office under IC 12-15-11 to provide physician services to Medicaid recipients.
            (B) Provide Medicaid services in the geographic area in which the recipient resides.
        (2) All providers that are described in IC 12-15-11-4.1 (c).
    (b) This section expires March 1, 2001.
".


    Delete page 2.
SOURCE: Page 3, line 1; (00)CR045501.3. -->     Page 3, delete lines 1 through 35.
    Renumber all SECTIONS consecutively.
    (Reference is to SB 455 as introduced.)

and when so amended that said bill do pass.

Committee Vote: Yeas 8, Nays 0.

____________________________________

    Miller
Chairperson


CR045501/DI 88    2000