SB 5927-S.E - DIGEST
(DIGEST AS ENACTED)

Declares an intent to create a legislative solution that: (1) Reduces the cost borne by the state to provide public health care coverage to low-income enrollees in managed health care systems;

(2) Protects enrollees and state purchased health care programs from balance billing by nonparticipating providers;

(3) Provides appropriate payment to health care providers for services provided to enrollees of state purchased health care programs; and

(4) Limits the risk for managed health care systems that contract with the state programs.

Requires the department of social and health services to monitor and report on the proportion of services provided by contracted providers and nonparticipating providers, by county, for each managed health care system to ensure that managed health care systems are meeting network adequacy requirements. Expires July 1, 2016.