HB 1143-1_ Filed 01/24/2000, 10:55

Text Box

    PREVAILED      Roll Call No. _______
    FAILED        Ayes _______
    WITHDRAWN        Noes _______




    I move that House Bill 1143 be amended to read as follows:

Page 44, between lines 35 and 36, begin a new paragraph and insert:
SOURCE: IC 27-13-36-1; (00)MO118901.32. -->     "SECTION 32. IC 27-13-36-1 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2000]: Sec. 1. (a) Each health maintenance organization shall appoint a medical director who has an unlimited license to practice medicine under IC 25-22.5. or an equivalent license issued by another state.
    (b) The medical director is responsible for oversight of treatment policies, protocols, quality assurance activities, and utilization management decisions of the health maintenance organization.
    (c) A health maintenance organization shall contract with or employ at least one (1) individual who holds an unlimited license to practice medicine under IC 25-22.5 to do the following:
        (1) Develop, in consultation with a group of appropriate providers, the health maintenance organization's treatment policies, protocols, and quality assurance activities.
        (2) Consult with the treating provider before an adverse utilization review decision is made.
    (d) Compliance with the most current standards or guidelines developed by the National Committee on Quality Assurance or a successor organization is sufficient to meet the requirements of this section.".
    Renumber all SECTIONS consecutively.
    (Reference is to HB 1143 as printed January 14, 2000.)


Representative Fry

DH 114301/DI pjc