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.".
and when so amended that said bill do pass.
Committee Vote: Yeas 8, Nays 0.
Miller
CR045501/DI 88 2000