HB 1461-1_ Filed 03/22/2001, 08:43
The Senate Committee on Health and Provider Services, to which was referred House Bill No. 1461,
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; (01)AM146112.1. -->
Page 1, delete lines 1 through 17, begin a new paragraph and insert:
SOURCE: IC 27-1-37; (01)AM146112.1. -->
IS ADDED TO THE INDIANA CODE
AS A NEW
CHAPTER TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2001]:
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
(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
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)AM146112.2. -->
SECTION 2. [EFFECTIVE JULY 1, 2001] (a)
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.
Delete pages 2 through 3.
(Reference is to HB 1461 as reprinted March 6, 2001.)
and when so amended that said bill do pass .
Committee Vote: Yeas 8, Nays 0.
Senator Miller, Chairperson
AM 146112/DI 98 2001