Nev. Rev. Stat. § 689B.015. Contracts between insurer and provider of health care: Prohibiting insurer from charging provider of health care fee for inclusion on list of providers given to insureds; form to obtain information on provider of health care; modification; schedule of fees: Group and Blanket Health Insurance — General Provisions – Nevada
Status: Enacted Year Enacted: 1999
Contracts between an insurer and provider of health care and prohibited from charging provider a fee for inclusion on list of providers given to insureds and to obtain information from the provider.
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Nev. Rev. Stat. §§ 689B.050 through 689B.069: Group and Blanket Health Insurance Law– Group Policies– Miscellaneous Provisions – Nevada
Status: Enacted Year Enacted: 1971
Insurers offering group or individual insurance policies must cover minimum medical services and drug related services. They must also include provisions concerning covreage for certain services, screenings and tests relating to wellness.
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Ohio Rev. Code § 1751.51. Restrictions on choice of providers: Health Insuring Corporation Law – Ohio
Status: Enacted Year Enacted: 1997
States that if a health plan restricts a patient’s choice of providers in any way that it must set forth a clear, concise, and complete statement of the restriction and a clear, concise, and complete …
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Okla. Stat. tit. 36, § 6902. Definitions: Health Maintenance Organization Act of 2003 – Oklahoma
Status: Enacted Year Enacted: 2003
Definitions related to the Health Maintenance Organization Act of 2003.
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Okla. Stat. tit. 36, § 6931. Coordination of benefits provisions: Health Maintenance Organization Act of 2003 – Oklahoma
Status: Enacted Year Enacted: 2003
A health maintenance organization is permitted, but not required, to adopt coordination of benefits provisions to avoid over insurance and to provide for the orderly payment of claims when an enrollee is covered by two …
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Okla. Stat. tit. 36, § 6933. Provision of basic health care services directly or by contract or agreement–Standards and procedures for selection of providers–Chiropractic and vision care services–Referrals: Health Maintenance Organization Act of 2003 – Oklahoma
Status: Enacted Year Enacted: 2003
A health maintenance organization shall provide basic health care services directly or by contract or agreement with other persons, corporations, institutions, associations, foundations or other legal entities, public or private, in accordance with the laws …
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Okla. Stat. tit. 36, § 6935. Services provided to out-of-state enrollees: Health Maintenance Organization Act of 2003 – Oklahoma
Status: Enacted Year Enacted: 2003
Basic health care services as herein provided may be furnished to enrollees of health maintenance organizations outside this state only in accordance with the laws of the state or of the United States that govern …
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Or. Rev. Stat. § 743A.082. Diabetes management for pregnant women: Health Insurance: Reimbursement of Claims – Oregon
Status: Enacted Year Enacted: 2013
States that a health benefit plan may not require a copayment or impose a coinsurance requirement or deductible on the covered services, medications and supplies that are medically necessary for a woman to manage her …
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Or. Rev. Stat. §§ 743B.450 through 743B.475. Health Benefit Plans: Individual and Group — Payment of Claims – Oregon
Status: Enacted Year Enacted: 2015
Provides provisions for payment of claims, performance-based incentive payments for primary care, and allows insurers to negotiate and enter into contracts for alternative rates of payment with providers. See definition section Or. Rev. Stat. § 743B.001.
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Or. Rev. Stat. §§ 743B.500 through 743B.505: Health Benefit Plans: Individual and Group – Oregon
Status: Enacted Year Enacted: 2015
Provides provider network access requirements and the methods for evaluating a provider network including access, consumer satisfaction, transparency, quality and cost containment.
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S 1045 – New Jersey
Introduced: 2018 Status: Inactive / Dead
ESTABLISHES CERTAIN STANDARDS FOR HEALTH BENEFITS PLANS WITH TIERED NETWORK. The bill requires a carrier that offers a health benefits plan with a tiered network to clearly and conspicuously state on the carrier’s website and …
S 1130 – New Jersey
Introduced: 2022 Status: In Process
Establishes certain standards for health benefits plans with tiered network. This bill places certain requirements on carriers offering health benefits plans with a tiered network. A tiered network is a managed care plan provider network …
S 1430 – New Jersey
Introduced: 2022 Status: In Process
Requires carriers to disclose selection standards for placement of health care providers in tiered health benefits plan network; establishes oversight monitor to review compliance.
S 1944 – New Jersey
Introduced: 2020 Status: Inactive / Dead
Requires carriers to disclose selection standards for placement of health care providers in tiered health benefits plan network; establishes oversight monitor to review compliance. This bill supplements the “Health Care Quality Act” to require health …
S 2151 – New Jersey
Introduced: 2020 Status: Inactive / Dead
Establishes certain standards for health benefits plans with tiered network. This bill places certain requirements on carriers offering health benefits plans with a tiered network. A tiered network is a managed care plan provider network …
S 220 (see compaion bill A 4305) – 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. …