HOUSE AMENDMENT

                                                  Bill No. HB 2339

    Amendment No. 6 (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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 5                                           ORIGINAL STAMP BELOW

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11  The Committee on Health Care Licensing & Regulation offered

12  the following:

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14         Amendment 

15         On page 49, line 24 through page 50, line 10,

16  remove from the bill:  all of said lines

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18  and insert in lieu thereof:  (4)  The organization shall

19  ensure that only a physician licensed under chapter 458 or

20  chapter 459, or an allopathic or osteopathic physician with an

21  active, unencumbered license in another state with similar

22  licensing requirements may render an adverse determination

23  regarding a service provided by a physician licensed in this

24  state. The organization shall submit to the treating provider

25  and the subscriber written notification regarding the

26  organization's adverse determination within 2 working days

27  after the subscriber or provider is notified of the adverse

28  determination. The written notification must include the

29  utilization review criteria or benefits provisions used in the

30  adverse determination, identify the physician who rendered the

31  adverse determination, and be signed by an authorized

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    File original & 9 copies    04/13/00
    hcs0005                     03:45 pm         02339-hcl -153655




                                                   HOUSE AMENDMENT

                                                  Bill No. HB 2339

    Amendment No. 6 (for drafter's use only)





 1  representative of the organization or the physician who

 2  rendered the adverse determination. The organization must

 3  include with the notification of an adverse determination

 4  information concerning the appeal process for adverse

 5  determinations.

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    File original & 9 copies    04/13/00
    hcs0005                     03:45 pm         02339-hcl -153655