HB 1461-1_ Filed 03/22/2001, 08:43

COMMITTEE REPORT




MR. PRESIDENT:

    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. -->     "SECTION 1. IC 27-1-37 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

IC 27-8-5-1 );
        (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 IC 5-10-8-7 (c).
    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 services.
    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) 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.
".
    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