Connecticut Seal

General Assembly

Amendment

 

February Session, 2014

LCO No. 4766

   
 

*SB0003504766SDO*

Offered by:

 

SEN. LOONEY, 11th Dist.

SEN. FASANO, 34th Dist.

 

To: Subst. Senate Bill No. 35

File No. 419

Cal. No. 286

"AN ACT CONCERNING NOTICE OF ACQUISITIONS, JOINT VENTURES AND AFFILIATIONS OF GROUP MEDICAL PRACTICES. "

After the last section, add the following and renumber sections and internal references accordingly:

"Sec. 501. (NEW) (Effective January 1, 2015) (a) As used in this section, (1) "contracting entity" means a health insurer, health care center, hospital service corporation, medical service corporation, fraternal benefit society, preferred provider network or other entity that provides health insurance of the types specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 of the general statutes and that contracts with health care providers to provide health care and medical services to insureds or enrollees, and (2) "health care provider" means a person licensed to provide health care services under chapters 370 to 373, inclusive, or 375 to 383, inclusive, or chapter 400j of the general statutes.

(b) (1) Each contract entered into, renewed, amended or continued on or after January 1, 2015, between a contracting entity and a health care provider shall include a provision that sets the reimbursement rate paid to such provider for a covered service at equal to or greater than the reimbursement rate such contracting entity pays for the same or similar service to the largest hospital, based on the number of beds, that is licensed pursuant to chapter 368v of the general statutes and located in the same county as the principal place of business of such health care provider.

(2) If such contracting entity does not contract with or provide reimbursement for services at such hospital, the reimbursement rate paid to the provider shall be equal to or greater than the reimbursement rate paid for the same or similar service to the hospital with which such contracting entity has a contract, that is licensed pursuant to chapter 368v of the general statutes and located nearest the principal place of business of the health care provider. "

This act shall take effect as follows and shall amend the following sections:

Sec. 501

January 1, 2015

New section