35 Pa. Cons. Stat. §§ 449.4-449.5 – Pennsylvania
Status: Enacted
Creates the Pennsylvania Health Care Cost Containment Council (PHC4), an independent state agency charged with increasing access to health care and reducing costs. The Council is comprised of representatives from the business community, organized labor, …
35 Pa. Cons. Stat. §§ 67.101-67.3104 – Pennsylvania
Status: Enacted
The “Right to Know Law,” provides that public records, unless otherwise protected by law, shall be available for inspection and duplication by the public in accordance with the law. The Right to Know Law applies …
35 Pa. Stat. and Cons. Stat. Ann. §§ 449.1 through 449.19: Health Care Cost Containment Act – Pennsylvania
Status: Enacted Year Enacted: 1986
Governs initiatives for cost containment of health care costs including the establishment of a Health Care Cost Containment Council, provisions regarding health care for the medically indigent, implementation of mandated health benefits, making data accumlated …
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35 Pa. Stat. and Cons. Stat. Ann. §§ 449.31 through 449.36: Health Care Practitioners Medicare Fee Control Act – Pennsylvania
Status: Enacted Year Enacted: 1990
The General Assembly declares its policy to be that, in accordance with the provisions of this act, providers of health care services should not charge or collect from a beneficiary of health insurance under Medicare …
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35 Pa. Stat. and Cons. Stat. Ann. §§ 960.1 through 960.7: Generic Equivalent Drug Law – Pennsylvania
Status: Enacted Year Enacted: 1976
It is the purpose of this act to permit consumers to secure necessary drugs at the most economical cost consistent with the professional discretion of the purchaser’s physician and pharmacist.
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40 Pa. Cons. Stat. § 1560. Supervision: Health Maintenance Organization – Pennsylvania
Status: Enacted Year Enacted: 1972
Applies to HMOs; All premium rates charged must be approved by and be on file with the Commissioner of Insurance.
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40 Pa. Cons. Stat. § 1561. Reports and examinations: Health Maintenance Organizations – Pennsylvania
Status: Enacted Year Enacted: 1972
Requires health maintenance organizations to file with the commissioner a statement summarizing its financial activities, which will be examined by the commissioner.
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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.
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40 Pa. Cons. Stat. § 991.2162. External grievance process: Quality Health Care Accountability and Protection – Pennsylvania
Status: Enacted Year Enacted: 1998
A managed care plan shall establish and maintain an external grievance process by which an enrollee or a health care provider with the written consent of the enrollee may appeal the denial of a grievance …
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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. §§ 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 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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410 Ill. Comp. Stat. §§ 50/1 through 50/5: Medical Patient Rights Act – Illinois
Status: Enacted Year Enacted: 1979
Patients have a right, regardless of source of payment, to examine and receive a reasonable explanation of his total bill for services rendered by his physician or health care provider, including the itemized charges for …
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42 R.I. Gen. Laws § 42-157-8. Reporting: Rhode Island Health Benefit Exchange – Rhode Island
Status: Enacted Year Enacted: 2015
HealthSource RI shall provide a monthly report to the chairpersons of the house finance committee and the senate finance committee which shall include, but not be limited to, the following information: actual enrollment data by market …
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42 R.I. Gen. Laws § 42-62-21. Health cost report: Catastrophic Health Insurance Plan (“CHIP”) Act – Rhode Island
Status: Enacted Year Enacted: 1974
The governor shall provide for a health cost report to be made not later than December 31 to the general assembly on legislative and administrative steps required
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