HB4438 HH&HR AMT 2-13 #1

    The Committee on Health and Human Resources moves to amend the bill, beginning on page one, by striking out the title of the bill in its entirety and inserting in lieu thereof a new title, to read as follows:

A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto a new article, designated §16-2L-1, §16-2L-2, §16-2L-3, §16-2L-4, §16-2L-5, §16-2L-6, §16-2L-7, §16-2L-8, §16-2L-9, §16-2L-10, §16-2L-11, §16-2L-12, §16-2L-13 and §16-2L-14, all relating to creating the Provider Sponsored Network Act; stating the purpose; making legislative findings; defining terms; describing the services to be performed and programs to be undertaken by a provider sponsored network; authorizing the Secretary of the Department of Health and Human Resources to recognize provider sponsored networks; assigning medicaid beneficiaries to a provider sponsored network; authorizing the Secretary of the Department of Health and Human Resources to contract with a provider sponsored network; providing for payment for services provided by a provider sponsored network; providing for participation of health care providers in a provider sponsored network; providing an exemption from anti-trust laws; addressing business and insurance risk; excluding insurance regulation; requiring studies and reports; providing for shared savings with the state and defining the shared amounts; providing minimum capital and surplus amounts; requiring that the designation of provider sponsored networks be an open application process using standards established by the secretary; providing rule-making authority and providing that reimbursement for reasonable costs will be paid by the network.”