The Senate Committee on Health and Provider Services, to which was referred House Bill No. 1871, 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)CR187101.1. -->
Page 1, between the enacting clause and line 1, begin a new
paragraph and insert:
SOURCE: IC 12-15-11.5-0.5; (01)CR187101.1. --> "SECTION 1. IC 12-15-11.5-0.5 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE DECEMBER 30, 2000 (RETROACTIVE)]: Sec. 0.5. This chapter does not apply to a managed care contractor that, on or before July 1, 2000, did not directly contract with a hospital (as defined in section 1 of this chapter) for the provision of services under the office's managed care program.".
SOURCE: Page 2, line 10; (01)CR187101.2. --> Page 2, delete lines 10 through 18, begin a new paragraph and insert:
" (c) If a hospital's reimbursement for nonemergency services that are provided to an individual described in section 2 of this chapter is established by:
(1) statute; or
(2) an agreement between the hospital and the individual's managed care contractor;
the hospital may not decline to provide nonemergency services to the individual on the basis that the individual is enrolled in the Medicaid risk based program.".
Page 2, line 23, after "(c)" insert " (e)".
Page 2, line 23, reset in roman "This section expires December
Page 2, line 23, after "2000." insert " 2002.".
Page 2, between lines 23 and 24, begin a new paragraph and insert:
" (f) Notwithstanding subsection (a), this section does not prohibit the office or the office's managed care contractor from directing individuals described in section 2 of this chapter to a hospital other than a hospital in a city where the patient resides if both of the following conditions exist:
(1) The patient is directed to a hospital other than a hospital in a city where the patient resides for the purpose of receiving medically necessary services.
(2) The type of medically necessary services to be received by the patient cannot be obtained in a hospital in a city where the patient resides.
SOURCE: IC 12-15-11.5-4.1; (01)CR187101.4. --> SECTION 4. IC 12-15-11.5-4.1 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE DECEMBER 30, 2000 (RETROACTIVE)]: Sec. 4.1. (a) A hospital that:
(1) does not have a contract in effect with the office's managed care contractor; but
(2) previously contracted or entered into an agreement with the office's managed care contractor for the provision of services under the office's managed care program;
shall be reimbursed for services provided to individuals described in section 2 of this chapter at rates equivalent to the rates negotiated under the hospital's most recent contract or agreement with the office's managed care contractor, as adjusted for inflation by the inflation adjustment factor described in subsection (b). However, the adjusted rates may not exceed the established Medicaid rates paid to Medicaid providers who are not contracted providers in the office's managed health care services program.
(b) For each state fiscal year beginning after June 30, 2001, an inflation adjustment factor shall be applied under subsection (a) that is the average of the percentage increase in the medical care component of the Consumer Price Index for all Urban Consumers and the percentage increase in the Consumer Price Index for all Urban Consumers, as published by the United States Bureau of Labor Statistics, for the twelve (12) month period ending in March preceding the beginning of the state fiscal year.
(c) This section expires December 31, 2002.".
Renumber all SECTIONS consecutively.
(Reference is to HB 1871 as printed February 21, 2001.)
and when so amended that said bill do pass.
Committee Vote: Yeas 9, Nays 0.
CR187101/DI 104 2001