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1997 SESSION
HB 790 Health maintenance organizations; continuing care facilities.
Introduced by: Eric I. Cantor | all patrons ... notes | add to my profiles
SUMMARY:
Health maintenance organizations; continuing care facilities; prohibited practices. Prohibits the referral of a health maintenance organization enrollee who is a resident of a continuing care facility (and whose agreement with such facility provides for health care services) to any nursing home other than that within the continuing care facility if (i) the enrollee's primary care physician determines that it is in the enrollee's best interests to do so, (ii) the continuing care facility's nursing home agrees to accept reimbursement at the rate applicable to such coverage under the enrollee's plan, and (iii) the continuing care facility's nursing home meets the health maintenance organization's guidelines pertaining to quality of care, utilization referral authorization, risk assumption, use of the health maintenance organization's network, and other criteria applicable to participating providers for the same services and supplies.
FULL TEXT
HISTORY
- 01/22/96 House: Presented & ordered printed 963414146
- 01/22/96 House: Referred to Committee on Corporations, Insurance and Banking
- 02/09/96 House: Continued to 1997 in C. I. B. (22-Y 0-N)
- 12/20/96 House: No action taken by Corporations, Insurance and Banking by voice vote