March 23, 2001
HOUSE BILL No. 1461
DIGEST OF HB 1461
(Updated March 21, 2001 2:56 PM - DI 98)
Citations Affected: IC 27-1; noncode.
Synopsis: Health care provider contracting. Prohibits specified entities
from requiring a health care provider to provide health care services to
enrollees of a health maintenance organization as a condition of
entering into a contract to provide health care services to individuals
other than enrollees of a health maintenance organization.
Effective: July 1, 2001.
(SENATE SPONSORS _ LAWSON C, ALEXA)
January 11, 2001, read first time and referred to Committee on Public Health.
February 27, 2001, amended, reported _ Do Pass.
March 5, 2001, read second time, amended, ordered engrossed.
March 6, 2001, engrossed. Read third time, passed. Yeas 92, nays 0.
March 13, 2001, read first time and referred to Committee on Health and Provider
March 22, 2001, amended, reported favorably _ Do Pass.
March 23, 2001
First Regular Session 112th General Assembly (2001)
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HOUSE BILL No. 1461
A BILL FOR AN ACT to amend the Indiana Code concerning
Be it enacted by the General Assembly of the State of Indiana:
SOURCE: IC 27-1-37; (01)EH1461.1.1. -->
SECTION 1. IC 27-1-37 IS ADDED TO THE INDIANA CODE AS
CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
Chapter 37. Health Provider Contracts
Sec. 1. As used in this chapter, "health maintenance
organization" means a person that undertakes to provide or
arrange for the delivery of health care services to individuals on a
prepaid basis, except for the individual's responsibility for
copayments or deductibles. The term does not include a staff-model
health maintenance organization that employs a group of providers
and that requires the providers to provide health care services
solely to individuals who are entitled to coverage under a contract
with the staff-model health maintenance organization or an
affiliate of the staff-model health maintenance organization.
Sec. 2. As used in this chapter, "health provider contract"
means an agreement with a provider relating to terms and
conditions of reimbursement for health care services provided to
an individual under:
(1) an employee welfare benefit plan (as defined in 29 U.S.C.
1002 et seq.);
(2) a policy of accident and sickness insurance (as defined in
(3) a contract with a health maintenance organization;
(4) a self-insurance program established under
IC 5-10-8-7(b); or
(5) a prepaid health care delivery plan entered into under
Sec. 3. (a) As used in this chapter, "person" means an
individual, an agency, a political subdivision, a partnership, a
corporation, an association, or any other entity.
(b) The term does not include a health care provider described
in IC 16-18-2-163(a)(1), IC 16-18-2-163(a)(2), IC 16-18-2-163(a)(3),
or IC 16-18-2-163(a)(4).
Sec. 4. As used in this chapter, "provider" means an individual
or entity licensed or legally authorized to provide health care
Sec. 5. A person may not require a provider, as a condition of
entering into a health provider contract for the provision of health
care services other than health care services to enrollees of a health
maintenance organization, to provide health care services to
enrollees of a health maintenance organization.
SOURCE: ; (01)EH1461.1.2. -->
SECTION 2. [EFFECTIVE JULY 1, 2001] (a) IC 27-1-37, as
added by this act, applies to a health provider contract that is
entered into or renewed after June 30, 2001.
(b) This SECTION expires June 30, 2005.