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1997 SESSION

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HB 2469 Accident and sickness insurance; essential community providers.

Introduced by: A. Donald McEachin | all patrons    ...    notes | add to my profiles

SUMMARY:

Accident and sickness insurance; essential community providers. Requires health insurers, nonstock corporations providing health services plans, and health maintenance organizations (HMOs) to include in their provider networks any essential community provider who agrees to meet network terms and conditions. The bill defines an essential community provider as one whose practice is located within the geographic area served by the health benefit program in which participation is sought, and who agrees to serve all individuals covered under such health benefit program who reside within such provider's practice area. To qualify as an essential community provider, a health care provider's patient base must comprise at least 20 percent Medicaid-eligible or other indigent patients. The Board of Health will annually certify essential community providers in accordance with these criteria. The Board is also authorized to decertify under the same criteria. Individuals making false statements in conjunction with essential community provider certification face criminal convictions (violations of this bill are punishable as Class 1 misdemeanors) and risk, upon conviction, the loss of their professional licenses.

Misdemeanor only.


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