House Journal: Page 1263: Wednesday, April 14, 1999

providing for continuity of care, discussion and advocacy of 

treatment options, coverage of emergency room services, utilization 
review requirements, and an external review process, and providing 
an effective date.
Chapman of Linn offered amendment H?1185 filed by her and 
Osterhaus of Jackson as follows:
H-1185
 1     Amend Senate File 276, as amended, passed, and
 2   reprinted by the Senate, as follows:
 3     1.  Page 7, line 18, by inserting after the word
 4   "under" the following:  "the carrier or organized
 5   delivery systems internal review process, if any, and
 6   under".
 7     2.  Page 7, line 19, by inserting after the word
 8   "process." the following:  "The carrier or organized
 9   delivery system's internal review process shall be
10   completed within fourteen days of a request for
11   internal review."
12     3.  Page 9, by striking lines 29 through 31 and
13   inserting the following:
14     "1.  The commissioner, at the time the commissioner
15   determines that a request is eligible for external
16   review, shall do all of the".
17     4.  Page 10, line 5, by inserting after the word
18   "member." the following:  "The independent review
19   entity or an individual who is part of an independent
20   review entity shall not have ever received more than
21   one percent of the entity's or individual's gross
22   annual income for any tax year from the carrier or
23   organized delivery system."
24     5.  Page 10, line 6, by striking the word "and".
25     6.  Page 10, line 7, by inserting after the word
26   "provider," the following:  "and the carrier or
27   organized delivery system,".
28     7.  Page 10, by striking lines 8 through 13 and
29   inserting the following:  "independent review entity
30   and of the enrollee's, treating health care
31   provider's, and carrier's or organized delivery
32   system's right to submit additional information.  The
33   enrollee, the enrollee's treating health care provider
34   acting on behalf of the enrollee, or the carrier or
35   organized delivery system may object to the
36   independent review entity selected by the commissioner
37   by notifying the commissioner within three".
38     8.  Page 10, by striking line 22 and inserting the
39   following:
40     "1A.  The carrier or organized delivery system,

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Last update: Thu Apr 15 13:40:03 CDT 1999
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