Introduced Version






HOUSE BILL No. 1300

_____


DIGEST OF INTRODUCED BILL



Citations Affected: IC 27-8-11-11; IC 27-13-15-6.

Synopsis: Health provider patient limits. Prohibits health plan contract provisions that would require a contracted provider to accept more than a certain number of patients.

Effective: July 1, 2009.





Welch, Brown C, Brown T, Dodge




    January 13, 2009, read first time and referred to Committee on Insurance.







Introduced

First Regular Session 116th General Assembly (2009)


PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in this style type.
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HOUSE BILL No. 1300



    A BILL FOR AN ACT to amend the Indiana Code concerning insurance.

Be it enacted by the General Assembly of the State of Indiana:

SOURCE: IC 27-8-11-11; (09)IN1300.1.1. -->     SECTION 1. IC 27-8-11-11 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2009]: Sec. 11. An agreement between an insurer and a provider that is entered into, amended, or renewed under section 3 of this chapter after June 30, 2009, may not include a provision that requires the provider to accept more insureds as patients than:
        (1) the number of insureds specified in the agreement; or
        (2) if there is not a specified number of insureds in the agreement, the number that, in the provider's professional judgment, is the greatest number of insureds that the provider is able to accept without endangering the provider's patients' access to or continuity of care.

SOURCE: IC 27-13-15-6; (09)IN1300.1.2. -->     SECTION 2. IC 27-13-15-6 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2009]: Sec. 6. A contract between a health maintenance organization and a participating provider that is entered into, amended, or renewed after June 30, 2009, may not include a

provision that requires a participating provider to accept more enrollees as patients than:
        (1) the number of enrollees specified in the contract; or
        (2) if there is not a specified number of enrollees in the contract, the number that, in the participating provider's professional judgment, is the greatest number of enrollees that the participating provider is able to accept without endangering the participating provider's patients' access to or continuity of care.