FORTY-THIRD LEGISLATURE SECOND SESSION, 1998 February 5, 1998 Mr. Speaker: Your BUSINESS AND INDUSTRY COMMITTEE, to whom has been referred HOUSE BILL 287 has had it under consideration and reports same with recommendation that it DO PASS, amended as follows: 1. On page 2, strike lines 19 through 22 and insert in lieu thereof: "A. Consistent with the terms of any contract between the department and a medicaid provider, the secretary shall have the right to be afforded access to such of the medicaid provider's records and personnel, as well as its subcontracts and that subcontractor's records and personnel, as may be necessary to ensure that the medicaid provider is complying with the terms of its contract with the department.". 2. On page 2, line 23, strike "The" and insert in lieu thereof "Upon not less than seven days written notice to a medicaid provider, the". 3. On page 3, strike lines 3 and 4. 4. Renumber succeeding paragraphs accordingly. 5. On page 3, line 11, after "(4)" insert "intentionally or with reckless disregard". 6. On page 3, line 15, after "(5)" insert "intentionally or with reckless disregard". 7. On page 4, line 1, strike "After" and insert in lieu thereof "Subject to the provisions of Subsection D of this section, after". 8. On page 4, line 8, strike "ten thousand dollars ($10,000)" and insert in lieu thereof "five thousand dollars ($5,000)". 9. On page 4, line 10, strike "occurrence of each" and insert in lieu thereof "separate occurrence of such". 10. On page 5, line 3, strike ", in which case the provider:" and insert in lieu thereof "pursuant to the terms of that contract.". 11. On page 5, strike lines 4 through 21 and insert in lieu thereof: "D. If a contract between the department and a medicaid provider explicitly specifies a dispute resolution mechanism for use in resolving disputes over performance of that contract, the dispute resolution mechanism specified in the contract shall be used to resolve such disputes in lieu of the mechanism set forth in Subsection C of this section. E. If a medicaid provider's contract so specifies the medicaid provider shall have the right to seek de novo review in district court of any decision by the secretary regarding a contractual dispute.". 12. On page 5, line 24, strike "five" and insert in lieu thereof "six". 13. On page 5, line 25, and page 6, line 1, strike "relating to" and insert in lieu thereof "that are necessary to verify the". 14. On page 6, line 2, after "recipient" insert "for which the medicaid provider received payment from the department to provide that benefit or service". 15. On page 6, line 4, after "recipient" insert "for which the medicaid provider received payment from the department to provide that benefit or service". 16. On page 6, lines 7 and 8, strike "or used for its administration" and insert in lieu thereof "under any contract between the department and the medicaid provider". 17. On page 6, line 9, strike "medicaid or". 18. On page 6, line 14, after "request" insert "unless the records are held by a subcontractor, agent or satellite office, in which case the records shall be made available within ten business days after the date of the request". 19. On page 6, between lines 22 and 23, insert the following new section: "Section 6. EFFECTIVE DATE.-- A. The provisions of the Medicaid Provider Act shall become effective for all initial contracts between the department and a managed care organization that are executed following any managed care procurement performed by the department that takes place on or after July 1, 1998. B. For all contracts between the department and any medicaid provider that is not a managed care organization, the provisions of the Medicaid Provider Act shall become effective on July 1, 1998."., and thence referred to the JUDICIARY COMMITTEE. Respectfully submitted, Fred Luna, Chairman Adopted Not Adopted (Chief Clerk) (Chief Clerk) Date The roll call vote was 9 For 0 Against Yes: 9 Excused: Alwin, Hobbs, J.G. Taylor Absent: Getty .122969A.1 G:\BILLTEXT\AMEND_98\H0287BI1