Bill > H1172

This bill aims to ensure protections for physicians and hospitals that contract with Medicaid managed care organizations. Specifically, it requires that reimbursement for hospital and physician services provided to Medicaid beneficiaries be subject to negotiation between providers and managed care organizations, and cannot be limited or determined through contracts between the state's Executive Office and the managed care organizations. The bill also prohibits the state from requiring hospitals to accept fee-for-service rates established by the Office of Medicaid for non-emergency services provided to beneficiaries enrolled in managed care organizations, including accountable care organizations and dual-eligible health plans. The only exception is that the state may require hospitals not in a managed care organization's network to accept fee-for-service rates for emergency services.

Health and Social Services

https://malegislature.gov/Bills/191/H1172