Introduced Version
HOUSE BILL No. 1459
_____
DIGEST OF INTRODUCED BILL
Citations Affected:
IC 27-8-11-7
;
IC 27-13-36-12.
Synopsis: Notice of amendments to health provider contracts.
Provides that an insurer or health maintenance organization that enters
into a contract with a physician or dentist to provide health care
services shall provide at least 90 days written notice to the physician or
dentist of an amendment to the contract. Allows a physician or dentist
to cease to provide health care services under the contract without
penalty if the physician or dentist receives the written notice and
chooses not to approve the amendment. Specifies that a contrary
contractual provision is void.
Effective: July 1, 2001.
Pelath
January 11, 2001, read first time and referred to Committee on Public Health.
Introduced
First Regular Session 112th General Assembly (2001)
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.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional
provision adopted), the text of the new provision will appear in
this style type. Also, the
word
NEW will appear in that style type in the introductory clause of each SECTION that adds
a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in
this style type or
this style type reconciles conflicts
between statutes enacted by the 2000 General Assembly.
HOUSE BILL No. 1459
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 27-8-11-7; (01)IN1459.1.1. -->
SECTION 1.
IC 27-8-11-7
IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2001]: Sec. 7. (a) As used in this section, "provider" means a:
(1) physician who is licensed under IC 25-22.5; or
(2) dentist who is licensed under IC 25-14.
(b) As used in this section, "provider contract" means a contract
entered into by a provider and an insurer to provide health care
services under a plan, policy, or contract that is issued, delivered,
or entered into by the insurer.
(c) An insurer that enters into a provider contract shall provide
written notice to the physician of any amendment to the provider
contract not less than ninety (90) days before the proposed effective
date of the amendment.
(d) A physician or dentist who receives notice under subsection
(c) and chooses not to approve the amendment may cease to
provide health care services under the provider contract on the
effective date of the amendment without penalty.
(e) A provider contract provision that is contrary to this section
is void.
SOURCE: IC 27-13-36-12; (01)IN1459.1.2. -->
SECTION 2.
IC 27-13-36-12
IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2001]: Sec. 12. (a) A health maintenance
organization or limited service health maintenance organization
that enters into a contract with a participating provider who is
licensed under:
(1) IC 25-22.5; or
(2) IC 25-14;
shall provide written notice to the participating provider of any
amendment to the contract not less than ninety (90) days before the
proposed effective date of the amendment.
(b) A participating provider who receives notice under
subsection (a) and chooses not to approve the amendment may
cease to provide health care services under the contract on the
effective date of the amendment without penalty.
(c) A contractual provision that is contrary to this section is
void.
SOURCE: ; (01)IN1459.1.3. -->
SECTION 3. [EFFECTIVE JULY 1, 2001]
(a)
IC 27-8-11-7
and
IC 27-13-36-12
, both as added by this act, apply to a contract with
a provider that is entered into, renewed, amended, or delivered
after June 30, 2001.
(b) This SECTION expires July 1, 2004.