Status: Enacted
Year Enacted: 1985
Requires HMOs to maintain a list of hospitals used, physicians employed, and estimated copayments, coinsurance, or deductible for any covered services.
Status: Enacted
Year Enacted: 2011
Describes requirements for Medicaid managed care networks and provider payment.
Status: Enacted
Year Enacted: 1976
A health care corporation may in its discretion limit the benefits that it will furnish, may divide such benefits as it elects to furnish into classes or kinds, and may furnish different benefits with different […]
Status: Enacted
Year Enacted: 1976
“Health care corporation” means a corporation established in accordance with the provisions of this chapter to administer one or more health care plans. “Health care plan” means a plan or arrangement under which health care […]
Status: Enacted
Year Enacted: 2016
Definitions relate to Chapter 20 Accurate Provider Directories (sections 33-20C-1 through 33-20C-7).
Status: Enacted
Year Enacted: 2016
An insurer shall post on its website a current and accurate electronic provider directory for each of its network plans and include information such as how the insurer designates the different provider tiers or levels.
Status: Enacted
Year Enacted: 2016
The insurer shall include in both its online and print directories a clearly identifiable telephone number and either a dedicated e-mail address or a link to a dedicated webpage that covered persons or the general […]
Status: Enacted
Year Enacted: 1988
It is the intent of the General Assembly to encourage health care cost containment while preserving quality of care by allowing health care insurers to enter into preferred provider arrangements and by establishing minimum standards […]
Haw. Rev. Stat. §§ 431:26-101 through 431:26-110: Health Benefit Plan Network Access and Adequacy – Hawaii
Status: Enacted
Year Enacted: 2017
For the information required by subsections (a)(3), (a)(4), and (b)(1) in a provider directory pertaining to a health care professional, hospital, or facility other than a hospital, the health carrier shall make available through electronic […]
Idaho Code Ann. §§ 56-260 through 266: Medicaid Cost Containment and Health Care Improvement Act – Idaho
Status: Enacted
Year Enacted: 2011
Directs the Department of Health and Welfare to present a plan for Medicaid managed care geared towards high-cost populations to sixty-first Idaho legislature (2011). The plan is to include, among other things, improved coordination of […]
Status: Enacted
Year Enacted: 2007
Provides prohibited conduct in “health maintenance organization” (HMO) contracts. Prohibits most favored nation (MFN) clauses and gag clauses; requires the participating provider to disclose the participating provider’s reimbursement rates under contracts with other health maintenance […]
Status: Enacted
Year Enacted: 1994
Statutes governing contracts between HMOs and participating providers. Provides HMO contracts may not prohibit the participating provider from disclosing the terms of the contract as it relates to financial or other incentives to limit medical […]
Status: Enacted
Year Enacted: 1986
Authorizes preferred provider arrangements between a health insurance carrier and a provider, stating the manner of payment may include capitation payments as a system of remuneration.
Status: Enacted
Year Enacted: 2016
A health carrier may offer a policy of accident and sickness insurance that requires some or all health care services to be rendered by participating providers, except that emergency services must be covered regardless of […]
Status: Enacted
Year Enacted: 1992
Expenses covered under the uninsurable health insurance plan shall include expenses for services of persons licensed to practice medicine and surgery which are medically necessary, and services of advanced registered nurse practitioners or physician assistants. […]
Status: Enacted
Year Enacted: 2006
The plan year handbook for self-insured plans shall contain the premiums, employee contributions, employer contributions, and a summary of benefits, copays, coinsurance, and deductibles for each plan.
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