Section 13F of chapter 118E, as appearing in the 2010 Official Edition, is hereby amended by striking subsection (a) in its entirety and inserting in place thereof the following new section: "(a) For disproportionate share hospitals, the executive office shall establish rates that equal the financial requirements of providing care to recipients of medical assistance, and further, the executive office shall classify as disproportionate share any geographically isolated hospital that provides inpatient and outpatient mental health services."
Chapter 176J, as appearing in the 2010 Official Edition, is amended in section 11 by striking subsection (e) in its entirety and adding in place thereof the following new section: "(e) In determining network adequacy under this section the commissioner of insurance may take into consideration factors such as the location of providers participating in the plan and employers or members that enroll in the plan, the range of services provided by providers in the plan and plan benefits that recognize and provide for extraordinary medical needs of members that may not be adequately dealt with by the providers within the plan network; and further, when calculating the tiering methodology for tiered network plans, the commissioner shall classify in the best tier any non –profit geographically isolated hospitals with a relative price as calculated by the center for health information and analysis of not greater than 1.1, and further, shall require any such hospital be an accepted provider in limited network products sold to members or employees who live or work in said hospital’s primary and secondary service area."
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