S.B.
242
HEALTH INSURANCE MARKET AMENDMENTS
Senate Committee
Amendments
Amendment 1 February 26, 2013 5:51 PM
Senator Lyle W. Hillyard
proposes the following amendments:
1. Page
2, Lines 43 through 44
:
43
participation on an insurer's provider panel
:
(A)
without first providing the physician with the due
44
process protections required by this section
; or
(B) in violation of Subsection (3)
.
2. Page
3, Lines 59 through 66
:
59
(3) (a)
{
A health insurer shall include a physician on its panel of providers for the
60
insurer's health benefit plans if the physician meets educational, training, and experience
61
requirements, and has demonstrated current competence.
62
(b)
}
A health insurer shall apply reasonable, nondiscriminatory standards for the
63
evaluation of a physician's qualifications
{
under this Subsection (3)
}
for inclusion on an insurer's
provider panel
. The decision to include a
64
physician on an insurer's provider panel shall be based on an objective evaluation of the
65
physician's qualifications,
training, experience, and competency,
free of anticompetitive intent or
purpose.
66
{
(c)
}
(b)
A health insurer shall not consider any of the following with regard to determining
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