Status: Enacted
Year Enacted: 2017
Statutes prohibit an insurer from prohibiting a preferred provider from discussing any specific or all treatment options with beneficiaries or from advocating on behalf of beneficiaries within utilization review. If the insurer does not have […]
27 R.I. Gen. Laws § 27-41-14.1. Prohibition against restraint on provider-patient communications: Health Maintenance Organization Act – Rhode Island
Status: Enacted
Year Enacted: 1997
No health maintenance organization shall refuse to contract with or compensate for covered services an otherwise eligible health care provider solely because the provider has in good faith communicated with one or more of his […]
40 Pa. Cons. Stat. § 991.2113. Medical gag clause prohibition: Managed Care Plan Requirements – Pennsylvania
Status: Enacted
Year Enacted: 1998
Statute that prohibits medical gag clauses.
40 Pa. Stat. and Pa. Cons. Stat. Ann. §§ 991.2101 through 991.2194: Quality Health Care Accountability and Protection – Pennsylvania
Status: Enacted
Year Enacted: 1998
Provisions governing managed care plans to ensure quality health care including prohibitions on financial incentives and gag clauses, standards regarding utilization review, prompt paymen of claims, and general responsibilities of managed care plans. Requires the […]
Status: Enacted
Year Enacted: 2003
Records in the State Medicaid Agency related to trade secrets, proprietary information, rebate amounts, and manufacturer pricing shall be confidential and shall not be a public record for purposes of Ala. Code § 41-3-1 (1975).
Status: Enacted
Year Enacted: 2016
Unless an entity has a sincerely held religious or moral belief, the entity may not restrict a health professional who is an employee of or affiliated or contracted with the entity for making a patient […]
Status: Enacted
Year Enacted: 2018
Provides regulation of pharmacy benefit managers, such as they may not prohibit a pharmacist or pharmacy from providing an insured individual information on the amount of the insured’s cost share for the insured’s prescription drug […]
Status: Enacted
Year Enacted: 1997
No participating provider may be prohibited, restricted, or penalized in any way from disclosing to any covered person any healthcare information that the participating provider deems appropriate regarding the nature of treatment, risks, or alternatives […]
Ark. Code §§ 23-99-401 through 23-99-416: Healthcare Providers — Arkansas Health Care Consumer Act – Arkansas
Status: Enacted
Year Enacted: 1997
As the state’s insurance sector becomes increasingly dominated by managed care features that include decisions regarding coverage and appropriateness of health care, there is a vital need to protect patients in this environment.
Status: Enacted
Year Enacted: 2011
Prohibits gag clauses preventing the disclosure to patients and enrollees of the quality of the services and a cost range of a procedure or a full course of treatment (including facility, professional and diagnostic fees).
Status: Enacted
Year Enacted: 2012
Prohibits gag clauses preventing the disclosure to qualified entities of all claims data for health care services supplied to enrollee or beneficiary of a service plan or self-funded health coverage arrangement administered by a service […]
Cal. Health & Safety Code §§ 1367 through 1374.195: Knox-Keene Health Care Service Plan Act of 1975 — Standards – California
Status: Enacted
Year Enacted: 1975
A health care service plan that issues, sells, renews, or offers health care service plan contracts for health care coverage in this state, including a grandfathered health plan, but not including specialized health care service […]
Status: Enacted
Year Enacted: 1951
Nothing in this section shall be construed to authorize an insurer to furnish or directly provide services of hospitals, or psychiatric health facilities, as defined in Section 1250.2 of the Health and Safety Code, or […]
Conn. Gen. Stat. § 38a-477f. Contract provisions prohibiting certain disclosures prohibited: Health Insurance: In General – Connecticut
Status: Enacted
Year Enacted: 2015
Prohibits contracts entered into after Jan 2016 from containing provisions that prohibit the disclosure of billed or allowed amounts, reimbursement rates or out of pocket costs and any data to the all-payer claims database program.
Status: Enacted
Year Enacted: 1997
States that no contract shall prohibit providers from discussing treatment options and services available in or out of network nor prohibit the provider from disclosing the method the managed care organization uses to pay the […]
D.C. Code § 31-3406. Quality assurance program: Health Maintenance Organizations – District of Columbia
Status: Enacted
Year Enacted: 1997
Health Maintenance Organizations should have an internal quality assurance program to monitor and evaluate health care services across all institutional and noninstitutional settings. The program shall meet the following minimum requirements.
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