Printer Friendly

AMENDMENT FOR PRINTED BILL

1058da

___________________ moved that HB 1058 be amended as follows:


    On the printed bill, delete everything after the enacting clause and insert:

"    Section1. That chapter 37-1 be amended by adding a NEW SECTION to read:

    Terms used in this chapter mean:

            (1)    "Health care provider," any provider of health care licensed pursuant to the provisions of either title 34 or 36 including physicians, hospitals, nursing home facilities, and any other health care facilities or providers;

            (2)    "Health insurance company," any entity that issues an insurance plan or product registered with the Division of Insurance pursuant to title 58;

            (3)    "Affiliate," any entity with which a health care provider shares a business ownership interest, partnership, affiliation, or other business connection by which the entities operate as part of a common enterprise. An affiliate of a company includes a subsidiary, company with a common ownership, health insurance plan, health network, health system entity, or other entity.

    Section 2. That chapter 37-1 be amended by adding a NEW SECTION to read:

    If a health care provider has an affiliate that is a health insurance company, that health care provider and its affiliates may not obstruct a patient's choice of health care by refusing to accept a patient's health insurance company's in-network payment or reasonably comparable payment. This prohibition to not obstruct a patient's choice only applies when the patient's health insurance company is an affiliate of another health care provider.

    Section 3. That chapter 37-1 be amended by adding a NEW SECTION to read:

    The division of insurance shall promulgate rules pursuant to chapter 1-26 to identify the criteria to be used to determine whether a health insurance company's in-network payment is a reasonably comparable payment in section 2 of this Act. A person, a state's attorney or the Attorney General, or an agency that has issued a license to a health care provider, may initiate an administrative contested case pursuant to chapter 1-26 to remedy the obstruction of a patient's choice of health care. The remedy may include the revocation of the license of a health care provider who obstructs a patient's choice of health care.

    Section 4. That chapter 37-1 be amended by adding a NEW SECTION to read:

    A person injured by a violation of section 2 of this Act may bring an action for appropriate injunctive or other equitable relief, damages sustained, taxable costs, and reasonable attorney's fees. The trier of facts shall increase the recovery under this section to three times the damages sustained. An action to recover damages under this section is barred if it is not commenced within four years after the claim for relief accrues."