Text: H05219 Text: H05221 Text: H05200 - H05299 Text: H Index Bills and Amendments: General Index Bill History: General Index
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1 1 Amend the amendment, H-5102, to House File 2298 as
1 2 follows:
1 3 #1. Page 1, line 3, by striking the word "clause."
1 4 and inserting the following: "clause and inserting
1 5 the following:
1 6 "Section 1. NEW SECTION. 514C.11 PATIENT ACCESS
1 7 TO TYPES OF PHYSICIANS UNDER MANAGED CARE HEALTH PLAN
1 8 OR INDEMNITY PLAN WITH LIMITED PROVIDER NETWORK.
1 9 Notwithstanding section 514C.6, a managed care
1 10 health plan or indemnity plan with a limited provider
1 11 network may provide patients limited access to each
1 12 type of physician, as defined in section 135.1 and
1 13 licensed under chapter 148, 150A, or 151. Such access
1 14 to a physician licensed under chapter 151 shall not be
1 15 conditioned upon a specific number of visits, but
1 16 shall be based upon the appropriate medical treatment.
1 17 If a physician determines that a referral should be
1 18 made to a physician licensed under another chapter, a
1 19 managed care health plan or indemnity plan with a
1 20 limited provider network may require that the referral
1 21 be made first to a provider designated by the plan.
1 22 Access to a nonparticipating physician may be
1 23 restricted or may be subject to different copayments,
1 24 deductibles, or premium rates, or may be excluded,
1 25 provided that a plan shall not differentiate or
1 26 exclude a physician directly or indirectly upon the
1 27 basis of the license held by the physician.
1 28 For purposes of this section, "managed care health
1 29 plan or indemnity plan with a limited provider
1 30 network" means a health maintenance organization,
1 31 organized delivery system, accountable health plan,
1 32 health care insurance plan which limits the number of
1 33 licensed physicians who can provide services under the
1 34 plan, preferred provider organization, exclusive
1 35 provider organization, restricted access network, or
1 36 similar health-care plan. For purposes of this sec-
1 37 tion, "physician" means physician as defined in
1 38 section 135.1 and licensed under chapter 148, 150A, or
1 39 151.""
1 40
1 41
1 42
1 43 MASCHER of Johnson
1 44 HF 2298.507 76
1 45 mj/jw
Text: H05219 Text: H05221 Text: H05200 - H05299 Text: H Index Bills and Amendments: General Index Bill History: General Index
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