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MS HB442
Bill
Status
2/3/2015
Primary Sponsor
Gary Chism
Click for details
AI Summary
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Requires health benefit plans to reimburse and allow participation by duly licensed physicians and podiatrists for services within their lawful scope of practice, effective July 1, 2015.
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Prohibits health benefit plans from discriminating against physicians located within their geographic coverage area who meet the plan's terms and conditions, with notification of acceptance required within 60 days of completed application.
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Allows health benefit plans to maintain different reimbursement rates for different physician types based on specialty scope and permits quality control measures like gatekeeper systems if applied equally to all providers in the same class.
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Clarifies that plans retain authority to set participation terms and conditions applied in a nondiscriminatory manner, and that the law applies to all health benefit plans including pre-paid coverage and multiple employer arrangements.
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Grants the Commissioner of Insurance enforcement authority and the ability to seek injunctions against health insurers violating these provisions.
Legislative Description
Medical providers; provide health benefit plans must allow participation by and reimbursement to if licensed and within scope of practice.
Last Action
Died In Committee
2/3/2015