SENATE AMENDMENT

    Bill No. SB 800

    Amendment No. 1

                            CHAMBER ACTION
              Senate                               House
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11  The Committee on Banking and Insurance recommended the

12  following amendment:

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14         Senate Amendment (with title amendment) 

15         On page 5, lines 5-26, delete those lines

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17  and insert:

18         6.  When a contract between a treating provider and the

19  state contracted health maintenance organization is terminated

20  for any reason other than for cause, each party shall allow

21  any enrollee for whom treatment was active to continue

22  coverage and care when medically necessary, through completion

23  of treatment of a condition for which the enrollee was

24  receiving care at the time of the termination, until the

25  enrollee selects another treating provider, or until the next

26  open enrollment period offered, whichever is longer, but no

27  longer than 9 months after termination of the contract. Each

28  party to the terminated contract shall allow an enrollee who

29  has initiated a course of prenatal care, regardless of the

30  trimester in which care was initiated, to continue care and

31  coverage until completion of postpartum care. This does not

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                                                  SENATE AMENDMENT

    Bill No. SB 800

    Amendment No. 1





 1  prevent a provider from refusing to continue to provide care

 2  to an enrollee who is abusive, noncompliant, or in arrears in

 3  payments for services provided. For care continued under this

 4  subparagraph, the program and the provider shall continue to

 5  be bound by the terms of the terminated contract. Changes made

 6  within 30 days after termination of a contract are effective

 7  only if agreed to by both parties.

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10  ================ T I T L E   A M E N D M E N T ===============

11  And the title is amended as follows:

12         On page 1, line 4, delete that line

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14  and insert:

15         a state contracted health maintenance

16         organization to provide an

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