HB 1300-4_ Filed 03/30/2009, 10:57 Miller
Adopted 3/30/2009

SENATE MOTION


MADAM PRESIDENT:

    I move
that Engrossed House Bill 1300 be amended to read as follows:

SOURCE: Page 2, line 8; (09)MO130009.2. -->     Page 2, between lines 8 and 9, begin a new paragraph and insert:
SOURCE: IC 27-8-11-11; (09)MO130009.2. -->     "SECTION 2. 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. (a) As used in this section, "noncontracted provider" means a provider that has not entered into an agreement with an insurer under IC 27-8-11-3.
     (b) If an insurer makes a payment to a covered individual for a health care service rendered by a noncontracted provider, the insurer shall include with the payment instrument written notice to the covered individual that includes the following:
        (1) A statement of the claims covered by the payment instrument.
        (2) The name and address of the provider submitting each claim.
        (3) The amount paid by the insurer for each claim.
        (4) Any amount of a claim that is the covered individual's responsibility.
        (5) A statement in at least 24 point bold type that:
            (A) instructs the covered individual that the payment must be used to pay the noncontracted provider if the covered individual has not paid the noncontracted provider in full;
            (B) specifies that paying the noncontracted provider is the covered individual's responsibility; and
            (C) states that the failure to make the payment violates the law and may result in collection proceedings.

SOURCE: IC 27-13-36-12; (09)MO130009.3. -->     SECTION 3. IC 27-13-36-12 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2009]: Sec. 12. (a) As used in this section, "nonparticipating provider" means a provider that has not entered into an agreement with a health maintenance organization to serve as a participating provider.
     (b) If a health maintenance organization makes a payment to an enrollee for a health care service rendered by a nonparticipating provider, the health maintenance organization shall include with the payment instrument written notice to the enrollee that includes the following:
        (1) A statement of the claims covered by the payment instrument.
        (2) The name and address of the provider submitting each claim.
        (3) The amount paid by the health maintenance organization for each claim.
        (4) Any amount of a claim that is the enrollee's responsibility.
        (5) A statement in at least 24 point bold type that:
            (A) instructs the enrollee that the payment must be used to pay the nonparticipating provider if the enrollee has not paid the nonparticipating provider in full;
            (B) specifies that paying the nonparticipating provider is the enrollee's responsibility; and
            (C) states that the failure to make the payment violates the law and may result in collection proceedings.
".
    Renumber all SECTIONS consecutively.
    (Reference is to EHB 1300 as printed March 27, 2009.)

________________________________________

Senator MILLER


MO130009/DI 97
2009