Bill > H1221

This bill aims to ensure protections for physicians and hospitals that contract with Medicaid managed care organizations. It proposes the following key provisions: 1. Reimbursement from Medicaid managed care organizations for hospital and physician services provided to beneficiaries shall be subject to negotiation between the providers and the managed care organizations, and shall not be limited or determined through contracts between the state's executive office and the managed care organizations, including accountable care organizations and dual-eligible health plans. 2. Reimbursement from Medicaid managed care organizations for services provided by acute and non-acute hospitals to beneficiaries shall also be subject to negotiation between the hospitals and the managed care organizations, and shall not be limited or determined through contracts between the executive office and the managed care organizations. 3. The executive office shall not, in its contracts with hospitals or through any other rule or regulation, require hospitals to accept fee-for-service rates established by the state's Medicaid office for non-emergency services provided to beneficiaries enrolled in managed care organizations, including accountable care organizations and dual-eligible health plans. The office may only require hospitals that are not in a managed care organization's provider network to accept fee-for-service rates for emergency services.

Health and Social Services

https://malegislature.gov/Bills/193/H1221