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2002 SESSION

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SJ 125 Study; noncontracting ancillary services providers.

Introduced by: Patricia S. Ticer | all patrons    ...    notes | add to my profiles

SUMMARY AS INTRODUCED:

Noncontracting ancillary services providers. Establishes a joint subcommittee to study issues relating to noncontracting ancillary services providers. This resolution describes situations whereby a consumer receives services, primarily surgery, within a participating hospital from a participating physician and assumes that all services in this setting will be provided by participating providers. Frequently, although health carriers notify consumers that coverage may be limited in situations requiring specialty care or hospital services, consumers are surprised and chagrined to receive unexpectedly large bills from noncontracting providers. In conducting its study, the joint subcommittee must (i) examine the circumstances that result in the provision of services in participating facilities by noncontracting providers; (ii) determine the pervasiveness of these circumstances within the Commonwealth; (iii) research other states' laws regarding the issues; and (iv) evaluate potential solutions. In pursuing these directives, the joint subcommittee will seek input from consumers, employers, physicians, including hospital-based physicians, hospitals and health systems, health maintenance organizations, other managed care organizations, and health insurance companies, insurance brokers, medical and other health care associations, and the Office of The Managed Care Ombudsman within the Bureau of Insurance. The Senate Rules Committee agreed to informally forward this resolution to the Joint Commission on Health Care for consideration during the 2002 interim session of the issues raised by the resolution.


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