SB 6391-S.E - DIGEST

(AS OF SENATE 2ND READING 2/14/00)

     Declares that, in cases where providers serve a disproportionately large number of low-income clients, the reimbursement rates from public programs to primary health care providers may prove insufficient to maintain their medical practices.

     Finds that determining where providers serve a disproportionately large number of low-income clients and developing strategies to provide additional compensation will help stabilize the current health care system, especially in rural areas.

     Authorizes the primary health care provider study.

     Directs the medical assistance administration and the health care authority to jointly conduct a state-wide study to determine payment sources for primary health care providers performing outpatient primary care services and primary care in hospital emergency rooms for the state's medical assistance programs, including healthy options and the basic health plan.  The purpose of the study is to determine which providers serve a relatively high number of low-income clients, and how that affects their medical practice.  The agencies are directed to use this data to develop proposals to support these providers' medical practices.

     Requires the medical assistance administration and the health care authority to report to the legislature by December 1, 2000, with the results of the primary health care provider study.  The report will include recommendations on:  (1) What constitutes a disproportionately high percentage of low-income clients;

     (2) possible payment adjustments for these providers;

     (3) methods to implement such a rate adjustment; and

     (4) what such a payment adjusted program will cost.