This bill amends the Managed Care Law to establish new standards for health carrier provider contracts, particularly in cases where a contract termination affects 1,000 or more patients. It allows the insurance commissioner to hold an informational public hearing within 15 business days of receiving notice of such a termination. The purpose of the hearing is to gather information and testimony regarding the potential impact on access to care in the community, but it does not grant the commissioner the authority to approve or disapprove the termination. Additionally, the bill mandates that health carriers provide written notice to affected patients within 5 business days of the contract termination, detailing their rights to continued access to the provider for 60 days post-termination.

The bill also repeals and reenacts a section of the Managed Care Law to ensure that all contracts entered into after July 1, 2003, include provisions for continued access to providers for covered persons, except in cases of unprofessional conduct. The continued access must be reimbursed according to the terms of the health benefit plan and the prior contract. Furthermore, the commissioner is authorized to adopt rules to specify the content and process for notifying consumers about contract terminations. Overall, the bill aims to enhance transparency and protect patient access to care during provider contract transitions.

Statutes affected:
Introduced: 420-J:8
As Amended by the Senate: 420-J:8
SB548 text: 420-J:8