House
File
2483
H-8389
Amend
House
File
2483
as
follows:
1
1.
Page
3,
after
line
29
by
inserting:
2
<
d.
A
managed
care
organization
shall
provide
written
3
notice
to
all
affected
individuals
at
least
sixty
days
prior
4
to
a
significant
change
in
administrative
procedures
relating
5
to
the
scope
or
coverage
of
benefits,
billings
and
collections
6
provisions,
provider
network
provisions,
member
or
provider
7
services,
prior
authorization
requirements,
or
any
other
terms
8
of
a
managed
care
contract
or
agreement
as
determined
by
the
9
department
of
human
services.
A
managed
care
organization
may
10
comply
with
the
requirement
of
providing
written
notice
under
11
this
paragraph
by
posting
such
written
notice
on
the
managed
12
care
organization’s
internet
site.
13
e.
The
department
of
human
services
shall
engage
dedicated
14
provider
relations
staff
to
assist
Medicaid
providers
in
15
resolving
billing
conflicts
with
managed
care
organizations
16
including
those
involving
denied
claims,
technical
omissions,
17
or
incomplete
information.
If
the
provider
relations
staff
18
observe
trends
evidencing
fraudulent
claims
or
improper
19
reimbursement,
the
staff
shall
forward
such
evidence
to
the
20
department
of
human
services
for
further
review.
21
f.
The
department
of
human
services
shall
adopt
rules
22
pursuant
to
chapter
17A
to
require
the
inclusion
by
a
managed
23
care
organization
of
advanced
registered
nurse
practitioners
24
and
physician
assistants
as
primary
care
providers
for
the
25
purposes
of
population
health
management.
>
26
______________________________
HEATON
of
Henry
-1-
HF2483.5345
(3)
87
pf/rh
1/
1
#1.