5304-S2 AMS ERWI S2331.2

2SSB 5304 - S AMDN  000160

By Senators Erwin and Roach

                             NOT ADOPTED 3/12/93 - ROLL CALL 17-30

    On page 93, beginning on line 13, after "enrollees." strike all material through "agreements." on line 19

2SSB 5304 - S AMD  000161

By Senators Erwin and Roach

                             NOT ADOPTED 3/12/93 - ROLL CALL 17-30

    On page 94, after line 8, insert the following:

    "(3) Permits licensed health care providers, on an individual or class basis, to provide health services or care for conditions included in the uniform benefits package to the extent that:

    (a) The provision of such health services or care is within the health care providers' permitted scope of practice; and

    (b) The providers agree to abide by standards related to:

    (i) Provision, utilization review, and cost containment of health services;

    (ii) Management and administrative procedures; and

    (iii) Provision of cost-effective and clinically efficacious health services;

    (4) Develops and implements procedures for:

    (a) Disclosure of provider contracting standards developed under subsection (3) of this section;

    (b) Termination for cause of health care providers who have failed to comply with standards developed under subsection (3) of this section; and

    (c) Appeal of a certified health plan's determination not to contract with an individual provider or provider group or to terminate a contract for cause;"

    Renumber the remaining subsections consecutively and correct any internal references accordingly.

                            --- END ---