Bill > H1289

This bill aims to ensure protections for physicians and hospitals that contract with Medicaid managed care organizations. It does this by: 1) requiring that reimbursement rates for hospital and physician services provided to Medicaid beneficiaries be subject to negotiation between providers and managed care organizations, rather than being limited or determined through contracts between the state and managed care organizations; 2) extending this negotiation requirement to reimbursement for acute and non-acute hospital services; and 3) prohibiting the state from requiring hospitals to accept fee-for-service Medicaid rates established by the state for non-emergency services provided to beneficiaries enrolled in managed care, though the state may require hospitals to accept those rates for emergency services if they are not in a managed care organization's provider network.

Health and Social Services

https://malegislature.gov/Bills/192/H1289