H-8389

   Amend House File 2483 as follows:
   1.  Page 3, after line 29 by inserting: 
   <d.  A managed care organization shall provide written notice to all affected individuals at least sixty days prior to a significant change in administrative procedures relating to the scope or coverage of benefits, billings and collections provisions, provider network provisions, member or provider services, prior authorization requirements, or any other terms of a managed care contract or agreement as determined by the department of human services. A managed care organization may comply with the requirement of providing written notice under this paragraph by posting such written notice on the managed care organization’s internet site.
   e.  The department of human services shall engage dedicated provider relations staff to assist Medicaid providers in resolving billing conflicts with managed care organizations including those involving denied claims, technical omissions, or incomplete information. If the provider relations staff observe trends evidencing fraudulent claims or improper reimbursement, the staff shall forward such evidence to the department of human services for further review.
   f.  The department of human services shall adopt rules pursuant to chapter 17A to require the inclusion by a managed care organization of advanced registered nurse practitioners and physician assistants as primary care providers for the purposes of population health management.>

______________________________
HEATON of Henry