- Committee -

SCS/SB 651 - This act requires a health carrier to allow any health care provider to participate in its network if that person satisfies all of the selection standards. This act will be known as the "Patient Freedom of Choice Act of 2002".

Currently, Section 354.606, RSMo, deals with contracts between health carriers (currently defined as HMOs) and health care professionals (currently defined as physicians or other health care practitioners who provide specific health services). New language clarifies the definition of "health carrier" to mean as defined in Section 376.1350, RSMo, which includes any entity subject to insurance laws in this state, including accident and sickness insurance, HMOs, nonprofit hospitals, and health service corporations, among others. Health carriers may not develop selection criteria in such a way that it will deny a health care professional the opportunity to become a participating provider if that professional meets all of the selection criteria and is willing to abide by all other terms and conditions. Current language also contains a provision that health carriers do not, however, need to hire more providers than necessary to maintain an adequate network.

This act is similar to SB 121 (2001).

ERIN MOTLEY