Introduced Version
HOUSE BILL No. 1362
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 16-21-9-10; IC 16-22-3-9.
Synopsis: Nonprofit and county hospitals. Requires a: (1) nonprofit
hospital; and (2) county hospital; to be certified Medicaid providers
and participate in the state Medicaid program. Requires specified
physicians of these hospitals to apply to be Medicaid providers, and if
approved, provide covered Medicaid services for Medicaid recipients.
Effective: July 1, 2008.
Brown C
January 16, 2008, read first time and referred to Committee on Public Health.
Introduced
Second Regular Session 115th General Assembly (2008)
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HOUSE BILL No. 1362
A BILL FOR AN ACT to amend the Indiana Code concerning
health.
Be it enacted by the General Assembly of the State of Indiana:
SOURCE: IC 16-21-9-10; (08)IN1362.1.1. -->
SECTION 1. IC 16-21-9-10 IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2008]: Sec. 10. (a) This section applies to a physician licensed
under IC 25-22.5 who:
(1) is employed by:
(A) a nonprofit hospital; or
(B) an entity affiliated with, controlled by, or managed by
a nonprofit hospital; or
(2) provides services under a contract with:
(A) a nonprofit hospital; or
(B) an entity affiliated with, controlled by, or managed by
a nonprofit hospital.
(b) A nonprofit hospital must be certified as a Medicaid
provider and participate in the state Medicaid program (IC 12-15).
(c) A physician described in subsection (a) shall:
(1) apply to the office of Medicaid policy and planning to be
a Medicaid provider; and
(2) if approved under subdivision (1), provide Medicaid
covered health care services to Medicaid recipients.
This subsection does not require a physician to provide care
outside the physician's medical specialty.
SOURCE: IC 16-22-3-9; (08)IN1362.1.2. -->
SECTION 2. IC 16-22-3-9 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2008]: Sec. 9. (a) The governing
board may determine appointments and reappointments to the medical
staff and delineate privileges of the members of the medical staff.
(b) All licensed physicians are eligible for membership on the
medical staff of the hospital, but the board may establish and enforce
reasonable standards and rules concerning the qualifications for the
following:
(1) Admission to the medical staff.
(2) Practice in the hospital.
(3) Retention of membership.
(4) The granting of medical staff privileges within the hospital.
(c) The standards and rules described in subsection (b) may not
discriminate against a licensed physician of any school of medicine but
may, in the interest of good patient care, consider the applicant's
postgraduate medical education, training, experience, and other facts
concerning the applicant that may affect the physician's professional
competence. The rules may include a requirement for the following:
(1) The submission of proof that a medical staff member has
qualified as a health care provider under IC 16-18-2-163.
(2) The performance of patient care and related duties in a manner
that is not disruptive to the delivery of quality medical care in the
hospital setting.
(3) Standards of quality medical care that recognize the efficient
and effective utilization of hospital resources as developed by the
medical staff.
(d) A county hospital must be certified as a Medicaid provider
and participate in the state Medicaid program (IC 12-15).
(e) A physician licensed under IC 25-22.5 who:
(1) is employed by:
(A) a county hospital; or
(B) an entity affiliated with, controlled by, or managed by
a county hospital; or
(2) provides services under a contract with:
(A) a county hospital; or
(B) an entity affiliated with, controlled by, or managed by
a county hospital.
shall apply to the office of Medicaid policy and planning to be a
Medicaid provider and, if approved, provide Medicaid covered
health care services to Medicaid recipients. This subsection does
not require a physician to provide care outside the physician's
medical specialty.
(d) (f) The medical staff shall originate and the board must approve
bylaws and rules for self-government. The bylaws must provide for a
hearing for a physician whose medical staff membership the medical
staff has recommended for termination.