Status: Enacted
Year Enacted: 2000
Definitions for the Managed Care Reform and Patient Rights Act.
Status: Enacted
Year Enacted: 2000
A health care plan shall establish and maintain an appeals procedure as outlined in this Act. Compliance with this Act’s appeals procedures shall satisfy a health care plan’s obligation to provide appeal procedures under any […]
Status: Enacted
Year Enacted: 2000
A health care plan that provides or that is required by law to provide coverage for emergency services shall provide coverage such that payment under this coverage is not dependent upon whether the services are […]
Status: Enacted
Year Enacted: 2000
If prior authorization for covered post-stabilization services is required by the health care plan, the plan shall provide access 24 hours a day, 7 days a week to persons designated by the plan to make […]
Status: Enacted
Year Enacted: 2011
When a beneficiary, insured, or enrollee utilizes a participating network hospital or a participating network ambulatory surgery center and, due to any reason, in network services for radiology, anesthesiology, pathology, emergency physician, or neonatology are […]
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 […]
Status: Enacted
Year Enacted: 1987
Statutes lay out indepenent review process for what constitutes “medically necessary” for a certain patient. Statutes require a health maintenance organization to file with the Director, prior to use, a notice of any change in […]
27 R.I. Gen. Laws § 27-18-76. Emergency services: Accident and Sickness Insurance Policies – Rhode Island
Status: Enacted
Year Enacted: 2012
If a nonprofit medical service corporation offering health insurance coverage provides any benefits with respect to services in an emergency department of a hospital, it must cover emergency services consistent with the rules of this […]
27 R.I. Gen. Laws § 27-19-66. Emergency services: Nonprofit Hospital Service Corporations – Rhode Island
Status: Enacted
Year Enacted: 2012
If a nonprofit medical service corporation offering health insurance coverage provides any benefits with respect to services in an emergency department of a hospital, it must cover emergency services consistent with the rules of this […]
27 R.I. Gen. Laws § 27-20-62. Emergency services: Nonprofit Medical Service Corporations – Rhode Island
Status: Enacted
Year Enacted: 2012
If a nonprofit medical service corporation offering health insurance coverage provides any benefits with respect to services in an emergency department of a hospital, it must cover emergency services consistent with the rules of this […]
27 R.I. Gen. Laws § 27-41-79. Emergency services: Health Maintenance Organization Act – Rhode Island
Status: Enacted
Year Enacted: 2012
If a nonprofit medical service corporation offering health insurance coverage provides any benefits with respect to services in an emergency department of a hospital, it must cover emergency services consistent with the rules of this […]
Status: Enacted
Year Enacted: 2001
Sections relate to billing practices for emergency services for managed care organizations.
Status: Enacted
Year Enacted: 2017
Limits the financial exposure of consumers who get care from a hospital or doctor that are part of their insurance provider’s network and are surprisingly billed by an out of network anesthesiologist, emergency-medicine doctor, surgical […]
Status: Enacted
Year Enacted: 2003
A hospital shall make a written or electronic copy of its charge description master available, either by posting an electronic copy of the charge description master on the hospital’s Internet Web site, or by making […]
Status: Enacted
Year Enacted: 1994
Sections include independent dispute resolution process for noncontracting individual health professional, reimbursement rate for noncontracting individual health professional, authorization for emergency services, and the “in-network cost-sharing amount” for services provided by noncontracting individual health professional.
Cal. Ins. Code §§ 10112.8 through 10112.82: Life and Disability Insurance — The Contract – California
Status: Enacted
Year Enacted: 2016
Sections provide “In-network cost-sharing amount” for services provided by noncontracting individual health professional, independent dispute resolution process for noncontracting individual health professional, and reimbursement rate for noncontracting individual health professional.
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