1998 Session

Budget Amendments - SB30 (Conference Report)

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Health Insurance Program (language only)

Item 4-6.03 #1c

Item 4-6.03 #1c

Positions and Employment
3: Miscellaneous & Part 4: General Provisions)

Page 412, after line 31, insert:
Any hospital that serves as the primary medical facility for state employees shall be allowed to participate in the State Employee Health Insurance Program pursuant to §2.1-20.1, Code of Virginia, provided that (1) such hospital is not a participating provider in the network, contracted by the Department of Personnel  Training, that serves state employees, and (2) such hospital enters into a written agreement with the Department of Personnel and Training as to the rates of reimbursement. The Department shall accept the lowest rates offered by the hospital from among the rates charged by the hospital to (1) its largest purchaser of care, (2) any state or  federal public program, or (3) any special rate developed by the hospital for the state employee health benefits program which is lower than either of the rates above.  If the Department and the hospital cannot come to an agreement, the Department shall reimburse the hospital at the rates contained in its final offer to the hospital until the dispute is resolved.  Any dispute shall be resolved through arbitration or through the procedures established by the Administrative Process Act, as the hospital may decide, without impairment of any residual right to judicial review."

(This amendment provides authority to the Department of Personnel and Training to enter into agreements with hospitals that are the primary medical facility for state employees, when such hospital is not a participating facility with Trigon.)