HB 1871-1_ Filed 02/20/2001, 15:18
Your Committee on Public Health , to which was referred House Bill 1871 , has
had the same under consideration and begs leave to report the same back to the House with the
recommendation that said bill be amended as follows:
SOURCE: Page 1, line 1; (01)AM187101.1. -->
Page 1, between the enacting clause and line 1, begin a new
paragraph and insert:
SOURCE: IC 12-15-11.5-2; (01)AM187101.1. -->
"SECTION 1. IC 12-15-11.5-2, AS ADDED BY P.L.142-2000,
SECTION 2, IS AMENDED TO READ AS FOLLOWS
[EFFECTIVE DECEMBER 30, 2000 (RETROACTIVE)]: Sec. 2.
The office's managed care contractor shall regard a hospital as a
contracted provider in the office's managed care services program,
which provides a capitated prepayment managed care system, for the
provision of medical services to each individual who:
(1) is eligible to receive services under IC 12-15 and has enrolled
in the office's managed care services program;
(2) resides in the same city in which the hospital is located; and
(3) has selected a primary care provider who:
(A) is a contracted provider with the office's managed care
(B) has medical staff privileges at the hospital.
(b) This section expires December 31, 2000.".
SOURCE: Page 1, line 7; (01)AM187101.1. -->
Page 1, between lines 7 and 8, begin a new paragraph and insert:
"(b) The prohibition in subsection (a) includes methodologies
that operate to lessen a primary medical provider's payment due
to the provider's referral of an individual described in section 2 of
this chapter to the hospital in the city where the individual resides.
(c) A hospital may not decline to provide nonemergency
services to an individual identified in section 2 of this chapter who
is referred to the hospital by a primary medical provider
identified in subsection (a):
(1) on the basis that the individual is enrolled in the
Medicaid risk based program; and
(2) as long as the hospital's reimbursement for the services
is established by statute or by agreement with the
individual's managed care contractor.
Page 1, line 8, delete "(b)" and insert " (d)
Renumber all SECTIONS consecutively.
(Reference is to HB 1871 as introduced.)
and when so amended that said bill do pass.
AM187101/DI 77 2001