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215 Ill. Comp. Stat. §§ 124/1 through 124/25: Network Adequacy and Transparency Act – Illinois
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 …
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27 R.I. Gen. Laws § 27-18.8-3. Certification of network plans: Health Care Accessibility and Quality Assurance Act – Rhode Island
Status: Enacted     Year Enacted: 2017
Describes the requirements for a network to be certified by the Insurance Commissioner. Prohibits most favored nation clauses. Originally enacted in 2003 as 23 R.I. Gen. Laws §§ 23-17.13-2 and 23-17.13-3. General certificate requirements: Health …
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27 R.I. Gen. Laws §§ 27-18.8-1 through 27-18.8-10: Health Care Accessibility and Quality Assurance Act – Rhode Island
Status: Enacted     Year Enacted: 2017
Describes the purpose of the Health Care Accessibility and Quality Assurance Act; provides the office shall establish reporting requirements to determine if health care entities and/or network plans are in compliance with the provisions of …
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820 Ill. Comp. Stat. § 305/8.1a. Preferred provider programs: Workers’ Compensation Act – Illinois
Status: Enacted     Year Enacted: 2011
Employers can use a preferred provider program for their workers’ compensation programs.
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A 1714 – New Jersey
Introduced: 2018    Status: Inactive / Dead    
REQUIRES HEALTH INSURANCE CARRIERS TO COMPLY WITH CERTAIN NETWORK ADEQUACY REQUIREMENTS. The bill prohibits the Commissioner of Banking and Insurance from issuing conditional approval of provider network adequacy. The bill provides that in the case …

A 1720 (see companion bill S 972) – New Jersey
Introduced: 2018    Status: Inactive / Dead    
REGULATES PHYSICIAN PROFILING PROGRAMS USED BY MANAGED CARE NETWORKS. Physician profiling programs are relatively new, and are designed to evaluate physicians participating in managed care plan networks, by measuring physicians’ performance based on quality and …

A 1870 – New Jersey
Introduced: 2018    Status: Inactive / Dead    
ESTABLISHES CERTAIN NETWORK ADEQUACY AND STANDARD APPLICATION REQUIREMENTS FOR HEALTH INSURANCE CARRIERS; REQUIRES DETERMINATION OF HOSPITAL DIVERSITY FOR TIERED NETWORKS. The bill prohibits the commissioner from issuing conditional approvals of provider network adequacy. Carriers must …

A 1871 – New Jersey
Introduced: 2018    Status: Inactive / Dead    
REQUIRES CARRIERS TO DISCLOSE SELECTION STANDARDS FOR, AND ESTABLISHES CERTAIN REQUIREMENTS REGARDING, PLACEMENT OF HEALTH CARE PROVIDERS IN TIERED HEALTH BENEFITS PLAN NETWORK. With respect to those various selection standards and other data, the bill …

A 1872 – New Jersey
Introduced: 2018    Status: Inactive / Dead    
ESTABLISHES “NEW JERSEY TASK FORCE ON TIERED HEALTH INSURANCE NETWORKS.” The purpose of the task force is to study the recent trend towards tiered health insurance networks, identify the impact of tiered health insurance networks …

A 2667 – New Jersey
Introduced: 2018    Status: Inactive / Dead    
REQUIRES DOBI TO DEVELOP SYSTEM TO REQUIRE CARRIERS TO CONSULT WITH HEALTH CARE PROVIDERS ON TIERED NETWORK MANAGED CARE PLANS. This bill supplements the “Health Care Quality Act,” to require the Commissioner of Banking and …

A 2667 – New Jersey
Introduced: 2018    Status: Inactive / Dead    
REQUIRES DOBI TO DEVELOP SYSTEM TO REQUIRE CARRIERS TO CONSULT WITH HEALTH CARE PROVIDERS ON TIERED NETWORK MANAGED CARE PLANS. This bill supplements the “Health Care Quality Act,” to require the Commissioner of Banking and …

A 3523 – New Jersey
Introduced: 2020    Status: Inactive / Dead    
Requires health insurance carriers to comply with certain network adequacy requirements. The bill prohibits the Commissioner of Banking and Insurance from issuing conditional approval of provider network adequacy. The bill provides that in the case …

A 4082 – New Jersey
Introduced: 2020    Status: Inactive / Dead    
Requires DOBI to develop system to require carriers to consult with health care providers on tiered network managed care plans. This bill supplements the “Health Care Quality Act,” to require the Commissioner of Banking and …

A 4305 (see companion bill S 220) – New Jersey
Introduced: 2018    Status: Inactive / Dead    
SETS LEVEL FOR HEALTH CARE BENEFITS; REQUIRES EMPLOYEE CONTRIBUTIONS; PROHIBITS REIMBURSEMENT OF MEDICARE PART B; ADDS MEMBER TO SHBP/SEHBP PLAN DESIGN COMMITTEES; REQUIRES RETIREES TO PURCHASE HEALTH BENEFITS THROUGH EXCHANGES; PROVIDES SUBSIDES FOR OUT-OF-POCKET COSTS. …

A 6022 – New York
Introduced: 2017    Status: Inactive / Dead    
Instructs the superintendent of insurance to deny policies imposing drug tiers based on expense or disease category and charging cost-sharing percentage for prescription medication

A 851 – New Jersey
Introduced: 2018    Status: Inactive / Dead    
SETS LEVEL FOR HEALTH CARE BENEFITS; REQUIRES EMPLOYEE CONTRIBUTIONS; PROHIBITS REIMBURSEMENT OF MEDICARE PART B; ADDS MEMBER TO SHBP/SEHBP PLAN DESIGN COMMITTEES; REQUIRES RETIREES TO PURCHASE HEALTH CARE THROUGH EXCHANGES. Under the bill, all government …

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