2001 REGULAR SESSION (71st)                                                                            A AB452 247

Amendment No. 247

 

Assembly Amendment to Assembly Bill No. 452                                                              (BDR 57‑1177)

Proposed by: Committee on Commerce and Labor

Amendment Box:

Resolves Conflicts with: N/A

Amends:         Summary:              Title:               Preamble:               Joint Sponsorship:

 

ASSEMBLY ACTION              Initial and Date              |SENATE ACTION                        Initial and Date

       Adopted       Lost                                               |          Adopted       Lost                                           

Concurred In                     Not                                                        |Concurred In  Not                                 

       Receded        Not                                               |         Receded        Not                                           

 

     Amend section 1, page 1, line 4, after “shall” by inserting:

use its best efforts to”.

     Amend section 1, page 1, line 6, by deleting “plan.” and inserting:

plan if the health center:

     (a) Meets all conditions imposed by the carrier on similarly situated providers of health care with which the carrier contracts, including, without limitation:

          (1) Certification for participation in the Medicaid or Medicare program; and

          (2) Requirements relating to the appropriate credentials for employees of providers of health care; and

     (b) Agrees to reasonable reimbursement rates that are generally consistent with those offered by the carrier to similarly situated providers of health care with which the carrier contracts.”.

     Amend sec. 3, page 1, line 16, after “shall” by inserting:

use its best efforts to”.

     Amend sec. 3, page 1, line 19, by deleting “enrollees.” and inserting:

enrollees if the health center:

     (a) Meets all conditions imposed by the carrier on similarly situated providers of health care with which the carrier contracts, including, without limitation:

          (1) Certification for participation in the Medicaid or Medicare program; and

          (2) Requirements relating to the appropriate credentials for employees of providers of health care; and

     (b) Agrees to reasonable reimbursement rates that are generally consistent with those offered by the carrier to similarly situated providers of health care with which the carrier contracts.”.

     Amend sec. 5, page 2, line 9, after “shall” by inserting:

use its best efforts to”.

     Amend sec. 5, page 2, line 12, by deleting “plan.” and inserting:

plan if the health center:

     (a) Meets all conditions imposed by the carrier on similarly situated providers of health care that are members of the carrier’s defined set of providers, including, without limitation:

          (1) Certification for participation in the Medicaid or Medicare program; and

          (2) Requirements relating to the appropriate credentials for employees of providers of health care; and

     (b) Agrees to reasonable reimbursement rates that are generally consistent with those offered by the carrier to similarly situated providers of health care that are members of the carrier’s defined set of providers.”.

     Amend sec. 8, page 3, line 1, after “shall” by inserting:

use its best efforts to”.

     Amend sec. 8, page 3, line 3, by deleting “enrollees.” and inserting:

enrollees if the health center:

     (a) Meets all conditions imposed by the organization on similarly situated providers of health care that are under contract with the organization, including, without limitation:

          (1) Certification for participation in the Medicaid or Medicare program; and

          (2) Requirements relating to the appropriate credentials for employees of providers of health care; and

     (b) Agrees to reasonable reimbursement rates that are generally consistent with those offered by the organization to similarly situated providers of health care that are under contract with the organization.”.

     Amend sec. 10, page 3, line 36, after “shall” by inserting:

use its best efforts to”.

     Amend sec. 10, page 3, line 38, by deleting “insureds.” and inserting:

insureds if the health center:

     (a) Meets all conditions imposed by the organization on similarly situated providers of health care that are under contract with the organization, including, without limitation:

          (1) Certification for participation in the Medicaid or Medicare program; and

          (2) Requirements relating to the appropriate credentials for employees of providers of health care; and

     (b) Agrees to reasonable reimbursement rates that are generally consistent with those offered by the organization to similarly situated providers of health care that are under contract with the organization.”.

     Amend sec. 15, page 5, line 42, by deleting:

“July 1, 2001” and inserting:

“January 1, 2002.”.

     Amend the summary of the bill to read as follows:

“SUMMARY—Requires certain providers of health insurance to contract with federally qualified health centers as providers of health care under certain circumstances. (BDR 57‑1177)”.