40 Pa. Stat. and Cons. Stat. Ann. §§ 1551 through 1568: Health Maintenance Organization Act – Pennsylvania
Status: Enacted Year Enacted: 1972
The purpose of this act is to permit and encourage the formation and regulation of health maintenance organizations and to authorize the Secretary of Health to provide technical advice and assistance to corporations and limited …
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40 Pa. Stat. and Cons. Stat. Ann. §§ 3001 through 3003: Insurance Reimbursement for Licensed Certified Nurse Midwife Services – Pennsylvania
Status: Enacted Year Enacted: 1982
Governs reimbursement for the services of a licensed certified nurse midwife.
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40 Pa. Stat. and Cons. Stat. Ann. §§ 3021 through 3026: Insurance Payment to Registered Nurse Law – Pennsylvania
Status: Enacted Year Enacted: 1986
When a service is performed by a certified registered nurse anesthetist, certified registered nurse practitioner, certified enterostomal therapy nurse, certified community health nurse, certified psychiatric mental health nurse or certified clinical nurse specialist, certified by …
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40 Pa. Stat. and Cons. Stat. Ann. §§ 3041 & 3042: Insurance Reimbursement for Hospital Emergency Facility Services – Pennsylvania
Status: Enacted Year Enacted: 1996
States that an insurer shall reimburse an insured or provider for medically necessary services that are provided in a hospital emergency facility due to a medical emergency
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40 Pa. Stat. and Cons. Stat. Ann. §§ 3101 through 3111: Medicare Supplement Insurance Act – Pennsylvania
Status: Enacted Year Enacted: 1983
Governs Medicare supplement insurance policies including provisions regarding prohibited policy provisions, minimum benefit standards, loss ratio standards, required disclosure provisions, and requirements for replacement.
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40 Pa. Stat. and Cons. Stat. Ann. §§ 323.1 through 323.8: The Insurance Department Act of 1921 — Examinations – Pennsylvania
Status: Enacted Year Enacted: 1992
The purpose of this article is to provide an effective and efficient system for examining the activities, operations, financial condition and affairs of all persons transacting the business of insurance in this Commonwealth and all …
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40 Pa. Stat. and Cons. Stat. Ann. §§ 3801.101 through 3801.315: Accident and Health Filing Reform Act — Federal Compliance – Pennsylvania
Status: Enacted Year Enacted: 2011
Requires that each insurer shall file with the department rates for individual accident, small group accident and health insurance policies which it proposes to issue on am individual or group basis in this Commonwealth for …
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40 Pa. Stat. and Cons. Stat. Ann. §§ 3801.501 through 3801.514: Accident and Health Filing Reform Act — Commonwealth Exclusivity – Pennsylvania
Status: Enacted Year Enacted: 2011
Each insurer, HMO, hospital plan corporation, professional health services plan corporation shall file with the department rates for accident and health insurance policies which it proposes to use in this Commonwealth for the department to …
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40 Pa. Stat. and Pa. Cons. Stat. Ann. §§ 1001-B through 1006-B: Fairness in Multiple Copayments – Pennsylvania
Status: Enacted Year Enacted: 2015
The general purpose of this article is to provide fairness for persons seeking medically necessary physical therapy, chiropractic and occupational therapy who are sharing the cost of the care pursuant to a health insurance policy …
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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 …
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40 Pa.Stat. and Pa. Cons. Stat. Ann. §§ 981-1 through 981-11: Health Care Insurance Individual Accessibility – Pennsylvania
Status: Enacted Year Enacted: 1998
It is necessary to maintain the Commonwealth’s sovereignty over the regulation of health insurance in this Commonwealth by complying with the requirements of the Health Insurance Portability and Accountability Act of 1996. This article is …
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40 R.I. Gen. Laws § 40-8-13.3. Payment for services provided by in state and out of state hospitals: Medical Assistance – Rhode Island
Status: Enacted Year Enacted: 2009
The department of human services and/or the secretary of exectuive office of health and human services is authorized to amend its rules and regulations in order to provide for payment to hospitals for services provided …
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40 R.I. Gen. Laws § 40-8-13.4. Rate methodology for payment for in state and out of state hospital services: Medical Assistance – Rhode Island
Status: Enacted Year Enacted: 2009
In order to improve efficiency and cost effectiveness, the executive office shall: With respect to inpatient services for persons in fee-for-service Medicaid, which is non-managed care, implement a new payment methodology for inpatient services utilizing …
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40 R.I. Gen. Laws § 40-8-13.5. Hospital Incentive Program: Medical Assistance – Rhode Island
Status: Enacted Year Enacted: 2015
The secretary of the executive office of health and human services is authorized to seek the federal authorities required to implement a hospital incentive program (HIP). The HIP shall provide the participating licensed hospitals the …
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40 R.I. Gen. Laws § 40-8-2. Definitions: Medical Assistance – Rhode Island
Status: Enacted Year Enacted: 1966
Definitions related to Medical Assistance
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40 R.I. Gen. Laws § 40-8-20.1. Prospective rate increments: Medical Assistance – Rhode Island
Status: Enacted Year Enacted: 2006
The department may consider the granting of a prospective rate that reflects demonstrated cost increases in excess of the rate that has been established by the application of the percentage increase
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