SB 242 IN

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Requires the office of Medicaid policy and planning (office) or a managed care organization to promptly cover physician services rendered in a hospital emergency department by a physician who has entered into a provider agreement with the office or managed care organization, without limiting what constitutes an emergency medical condition. Specifies considerations that must be made in determining whether the prudent layperson standard has been met. Prohibits any delay in or denial of compensation to the physician unless the cause of the delay or denial is specifically provided for in: (1) the Medicaid managed care law; (2) an administrative rule adopted under the Medicaid managed care law; (3) the federal administrative rules on Medicaid managed care; or (4) the provider agreement. Prohibits a managed care organization from denying an emergency services claim solely because the claim code is not listed on the autopay list.

• Tyler Johnson Republican · author
• Justin Busch Republican · author

1. Jan 13, 2025 Authored by Senator Johnson T · upper
2. Jan 13, 2025 First reading: referred to Committee on Health and Provider Services · upper
3. Feb 6, 2025 Senator Busch added as second author · upper
4. Feb 6, 2025 Committee report: amend do pass adopted; reassigned to Committee on Appropriations · upper