SB 276-3_ Filed 02/25/2002, 07:59 Brown T


Text Box


    PREVAILED      Roll Call No. _______
    FAILED        Ayes _______
    WITHDRAWN        Noes _______
    RULED OUT OF ORDER


[

HOUSE MOTION ____

]

MR. SPEAKER:

    I move that Engrossed Senate Bill 276 be amended to read as follows:

SOURCE: Page 16, line 14; (02)MO027602.16. -->     Page 16, between lines 14 and 15, begin a new paragraph and insert:
SOURCE: IC 27-13-36-9.5; (02)MO027602.6. -->     "SECTION 6. IC 27-13-36-9.5 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2002]: Sec. 9.5. (a) Notwithstanding IC 27-13-36.2, a provider who is not a participating provider and who provides services, including emergency services, that a health maintenance organization or a limited service health maintenance organization is required to pay a nonparticipating provider, is considered to have filed a proper and complete claim if the provider submits the following information:
        (1) The name of the enrollee who received services.
        (2) The address of the enrollee.
        (3) The date of service.
        (4) The Current Procedural Terminology (CPT) code.
        (5) The International Classification of Diseases (ICD) disease classification.
        (6) The name and address of the provider.
        (7) Information on the enrollee's benefit card that is specific to the enrollee.
        (8) Tax identification information of the provider.
    (b) A claim for an evaluation and management code (as defined by the latest edition of the Current Procedural Terminology Manual) that meets the requirements under subsection (a) must be

paid to the provider not more than fourteen (14) days after the claim is submitted.
    (c) If a claim is not for
an evaluation and management code (as defined by the latest edition of the Current Procedural Terminology Manual), the health maintenance organization or the limited service health maintenance organization may require the provider to submit information in addition to the information required under subsection (a). However, the request for additional information under this subsection must be made not more than thirty (30) days after the provider has submitted a claim or the claim must be paid.".
    Renumber all SECTIONS consecutively.
    (Reference is to ESB 276 as printed February 19, 2002.)

________________________________________

Representative Brown T


MO027602/DI 104     2002