HB 6669 – Connecticut
Introduced: 2023 Status: Enacted Year Enacted: 2023
An Act Protecting Patients And Prohibiting Unnecessary Health Care Costs. Prohibits all-or-nothing clauses, anti-steering clauses, anti-tiering clauses, and gag clauses in contracts entered or renewed by a health care provider, carrier, or plan administrator. Requires …
HB 872 – Georgia
Introduced: 2018 Status: Inactive / Dead
RELATING TO INSURANCE: A bill to require insurers to develop selection standards for provider participation; to provide for definitions; to provide for tiered network standards; to provide for certain insurer notifications prior to provider termination …
HCR 9 – Idaho
Introduced: 2023 Status: Enacted
The Legislative Council is authorized to establish a task force to undertake and complete a study of Medicaid managed care programs, including comparison of the costs and benefits of Medicaid managed care services and value-based …
HF 1340 (see companion bill SF 1229) – Minnesota
Introduced: 2019 Status: Inactive / Dead
Mental health benefits and other medical benefits parity required, and accountability from commissioners of health and commerce required. This bill defines nonquantitative treatment limitations and requires all health plans to apply them in the same …
HF 254 (see companion bill SF 379) – Minnesota
Introduced: 2019 Status: Inactive / Dead
Mental health benefits and other medical benefits parity required, mental health and substance use disorder defined, health plan transparency required, and commissioners of health and commerce accountability required.
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 …
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Ind. Code § 27-13-15-4. Participating provider agreement prohibitions: Health Maintenance Organizations– Participating Providers; Contracts and Legal Actions – Indiana
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 …
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Ind. Code §§ 27-13-15-0.1 through 27-13-15-3: Health Maintenance Organizations– Participating Providers; Contracts and Legal Actions – Indiana
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 …
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Iowa Code §§ 514F.1 through 514F.7: Preferred Provider Arrangements – Iowa
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.
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Kan. Stat. Ann. § 40-2,195. Exclusive provider organization policy; requirements; exceptions; definitions: Insurance — General Provisions – Kansas
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 …
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Kan. Stat. Ann. § 40-2123. Same; expenses and services covered under the plan; exclusions; plan not subject to coverages mandated by other laws: Insurance– Kansas Uninsurable Health Insurance Plan Act – Kansas
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. …
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Ky. Rev. Stat. § 18A.2254. Self-insured plan for public employees; contract for third-party administrator; formulary change; health reimbursement account, health flexible spending account, or health savings account; public employee health insurance trust fund; annual audit; quarterly status reports: Health Coverage – Kentucky
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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Ky. Rev. Stat. § 304.17A-550. Out-of-network benefits: Managed Care Plans – Kentucky
Status: Enacted Year Enacted: 1998
An insurer that offers a managed care plan shall offer a health benefit plan with out-of-network benefits to every contract holder. The plan with out-of-network benefits may require that an enrollee pre-certify selected services and …
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Ky. Rev. Stat. § 304.17A-576. Notice by managed care plan insurer of health care provider’s application for credentialing; payments to applicant: Managed Care Plans – Kentucky
Status: Enacted Year Enacted: 2008
An insurer issuing a managed care plan shall notify an applicant of its determination regarding a properly submitted application for credentialing within forty-five (45) days of receipt of an application containing all information required by …
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Ky. Rev. Stat. § 304.17A-580. Education of insured about appropriate use of emergency and medical services; coverage of emergency medical conditions and emergency department services; emergency personnel to contact primary care provider or insurer; exclusion of limited-benefit health insurance policies: Managed Care Plans – Kentucky
Status: Enacted Year Enacted: 1998
An insurer offering health benefit plans shall cover emergency medical conditions and shall pay for emergency department screening and stabilization services both in-network and out-of-network without prior authorization for conditions that reasonably appear to a …
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Ky. Rev. Stat. § 304.17A-700. Definitions for KRS 304.17A-700 to 304.17A-730 and KRS 205.593, 304.14.135, and 304.99-123: Payment of Claims – Kentucky
Status: Enacted Year Enacted: 2000
Provides defintions for sections 304.17A-700 to 304.17A-730 and 205.593, 304.14.135, and 304.99-123.
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