DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part of the
legislative instrument. The keyword, one-liner, abstract, and digest do not constitute part of the law
or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 195 Original 2020 Regular Session Dustin Miller
Abstract: Removes the requirement to submit proof of active hospital privileges for a new
healthcare provider in a group practice who bills an insurer using the group practice's
identification number prior to credentialing.
Present law requires, under certain circumstances, a health insurance issuer contracting with a group
of healthcare providers that bills the health insurance issuer using a group identification number to
pay the contracted reimbursement rate of the provider group for covered healthcare services rendered
by a new provider to the group without healthcare provider credentialing in either of the following
circumstances:
(1)The new provider has already been credentialed by the health insurance issuer and the
provider's credentialing is still active with the issuer.
(2)The health insurance issuer has received the required credentialing application and
information, including proof of active hospital privileges, from the new provider and the
issuer has not notified the provider group that credentialing of the new provider has been
denied.
Proposed law retains present law but removes the requirement that the new provider submit proof
of active hospital privileges.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Amends R.S. 22:1874(A)(5)(a)(ii))