HB 218

Abstract

Health insurance; health care provider panels; continuity of care. Requires a provider to continue to render health care services to any of the carrier's enrollees who have an existing provider-patient relationship with the provider for a period of at least 90 days from the date of a provider's termination from the carrier's provider panel, except when a provider is terminated for cause. The bill provides that for an enrollee who has an existing provider-patient relationship with a provider, and, at the time of the provider's termination, (i) has been medically confirmed to be pregnant, the provider is required to continue care through the postpartum period; (ii) is determined to be terminally ill, the provider is required to continue care for the remainder of the enrollee's life; (iii) has been determined by a medical professional to have a life-threatening condition, the provider is required to continue care for up to 180 days; and (iv) is admitted to and receiving treatment in an inpatient facility, the provider is required to continue care until the enrollee is discharged from the inpatient facility. Under current law, the carrier is required to permit the provider to provide such continuity of care. The bill provides that the continuity of care provisions also apply to plans administered by the Department of Medical Assistance Services that provide benefits pursuant to Title XIX or Title XXI of the Social Security Act.

Health insurance; health care provider panels;continuity of care. Requires a provider to continue to renderhealth care services to any of the carrier's enrollees for a periodof at least 90 days from the date of a provider's termination fromthe carrier's provider panel, except when a provider is terminatedfor cause. The bill provides that for an enrollee who, at the timeof a provider's terminations, (i) has been medically confirmed tobe pregnant, the provider is required to continue care through thepostpartum period; (ii) is determined to be terminally ill, the provideris required to continue care for the remainder of the enrollee'slife; (iii) has been determined by a medical professional to havea life-threatening condition, the provider is required to continuecare for up to 180 days; and (iv) is admitted to and receiving treatmentin an inpatient facility, the provider is required to continue careuntil the enrollee is discharged from the inpatient facility. Undercurrent law, the carrier is required to permit the provider to providesuch continuity of care. The bill provides that the continuity ofcare provisions also apply to plans administered by the Departmentof Medical Assistance Services that provide benefits pursuant to Title XIX or Title XXI of the Social Security Act.