20 Ill. Comp. Stat. §§ 1340/1 through 1340/25: Regional Integrated Behavioral Health Networks Act – Illinois
Status: Enacted Year Enacted: 2012
Each Network shall develop a plan for its respective region that addresses the following: inventory of all mental health and substance use disorder services; identification of unmet community needs, identification of opportunities to improve access …
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210 Ill. Comp. Stat. §§ 26/1 through 26/30: Accountable Care Organization Clinical Laboratory Testing Advisory Board Act – Illinois
Status: Enacted Year Enacted: 2015
Statutes require that every accountable care organization providing diagnosis and treatment for patients in Illinois must establish an advisory board to consider and recommend guidelines or protocols for clinical laboratory testing.
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305 Ill. Comp. Stat. § 5/5-30.1. Managed care protections: Medical Assistance – Illinois
Status: Enacted Year Enacted: 2014
An MCO shall pay any provider of emergency services that does not have in effect a contract with the contracted Medicaid MCO. The default rate of reimbursement shall be the rate paid under Illinois Medicaid …
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A 02393 (see companion bill S 03462) – New York
Introduced: 2019 Status: Inactive / Dead
Enacts provisions relating to collective negotiations by health care providers with certain health care plans in certain counties; applies to health benefit plans that provide benefits for medical or surgical expenses incurred as a result …
Ariz. Rev. Stat. § 20-1069.01. Right to open enrollment period; enrollees; definitions: Health Care Services Organizations – Arizona
Status: Enacted Year Enacted: 2000
Managed Care Accountability Act: Statute makes numerous changes to statutes governing managed health care plans relating to health care services oversight, the medical decision making process, medical directors, standing referrals, the expedited review process, prescription …
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Ariz. Rev. Stat. § 20-1072. Nonliability of enrollees for provider or hospital charges; penalty: Health Care Services Organizations – Arizona
Status: Enacted Year Enacted: 2000
Managed Care Accountability Act: Statute makes numerous changes to statutes governing managed health care plans relating to health care services oversight, the medical decision making process, medical directors, standing referrals, the expedited review process, prescription …
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Ariz. Rev. Stat. § 20-1074. Contract termination; duty to report; provision for continued services during insolvency; definitions: Health Care Services Organizations – Arizona
Status: Enacted Year Enacted: 2000
Managed Care Accountability Act: Statute makes numerous changes to statutes governing managed health care plans relating to health care services oversight, the medical decision making process, medical directors, standing referrals, the expedited review process, prescription …
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Ariz. Rev. Stat. § 20-1379. Guaranteed availability of individual health insurance coverage; prior group coverage; definitions: Disability Insurance – Arizona
Status: Enacted Year Enacted: 2000
Every health care insurer that offers individual health insurance coverage in the individual market in this state shall provide guaranteed availability of coverage to an eligible individual who desires to enroll in individual health insurance coverage. Must disclose certain information about premiums …
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Colo. Rev. Stat. § 25.5-5-419. Accountable care collaborative-reporting-rules: Statewide Managed Care System – Colorado
Status: Enacted Year Enacted: 2017
States the creation of the accountable care collaborative, developed to improve member helath and reduce costs for Medicaid beneficiaries. Describes the core components of accountable care collaborative, such as establishing primary care medical homes, providing …
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Colo. Rev. Stat. § 6-18-301. Legislative Declaration: Health Care Coverage Collaboratives – Provider Networks – Colorado
Status: Enacted Year Enacted: 1994
Encouages collaboratives arrangements of physicians to promote market based competition among providers.
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Colo. Rev. Stat. § 6-18-301.5. Provider Networks-Definitions: Health Care Coverage Collaboratives – Provider Networks – Colorado
Status: Enacted Year Enacted: 2004
Definitions for health care providers and healthcare networks, as defined in Colorado.
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Colo. Rev. Stat. § 6-18-302. Health care coverage cooperatives-creation of provider networks-requirements: Health Care Coverage Collaboratives – Provider Networks – Colorado
Status: Enacted Year Enacted: 1994
Authorizes providers to conduct business collaboratively as provider networks. All provider networks that do business as insurance companies must hold a certificate of authenticity from the insurance commissioner. Also contains requirements for all providers that …
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Colo. Rev. Stat. § 6-18-303. Effect on scope of practice – limited exception to prohibitions on corporate practice of licensed health care providers: Provider Networks – Colorado
Status: Enacted Year Enacted: 1994
The fact that an entity or provider is a member of a provider network shall not exempt such entity from any licensure or scope of practice statute. This includes other employment and joint venture relationships.
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Colo. Rev. Stat. § 6-18-304. Competitive behavior-restraints of trade prohibited: Health Care Coverage Collaboratives – Provider Networks – Colorado
Status: Enacted Year Enacted: 1994
Describes the creation of provider networks and defines limitations, such as requirements if it participates in the business of insurance and licensure.
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Conn. Gen. Stat. § 17b-263c. Medical homes. Regulations: Medical Assistance – Connecticut
Status: Enacted Year Enacted: 2011
Establishes medical homes as a model for delivering care to recipients under the medical assistance programs.
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Fla. Stat. §§ 409.961 through 409.977: Medicaid Managed Care – Florida
Status: Enacted Year Enacted: 2011
Describes requirements for Medicaid managed care networks and provider payment.
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