SCS/HB 1302 - This act defines "Essential Community Providers" to include physicians who practice in medically underserved areas as determined by the federal Department of Health and Human Services. Such Essential Community Providers must spend at least 20 hours a week in the shortage areas, and they must be available to patients in the evenings and on weekends. Such providers must have hospital privileges and they cannot be direct employees of a health care insurer. The act requires that contracts and agreements between Essential Community Providers and health insurers must contain terms as favorable to the Essential Community Provider as to other physicians within the scope of rendered services. Physicians may apply to the Director of the Department of Health to be named an Essential Community Provider.

The act also adds language that relates to reimbursements from health insurers. Insurers are required to provide proper reimbursement for an insurance claim within 45 days after the receipt of a claim. Failure to provide a reimbursement for a claim without good cause forces an insurer to pay interest on such reimbursement at a monthly rate of 1.5%.
JOHN MESSMER