HB 1871-1_ Filed 02/20/2001, 15:18
Adopted 2/20/2001

Text Box

Adopted Rejected







    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. (a) 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

contractor; and
            (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.


Representative Brown C

AM187101/DI 77    2001