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Illinois Compiled Statutes-Insurance-215 ILCS 105/ …

WEB(H) A health plan offered under Chapter 89 of title 5, United States Code. (I) A public health plan (as defined in regulations consistent with Section 104 of the Health

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URL: https://managedcarelegaldatabase.org/state-law/chapter-215-insurance-act-105-comprehensive-health-insurance-plan-act/

Definitions of “Screening” and “Medical Necessity” H-320.953

WEBMedical Necessity-Definition. (1) Our AMA defines screening as: Health care services or products provided to an individual without apparent signs or symptoms …

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Self-funded Healthcare Plan Opt-in to the Surprise Billing …

WEB08/02/2023 Georgia Sections 33-20F-1 through 33-20F-5 Definitions; Opt-in by ERISA self-funded plans; Departmental website; exemption; Powers of Commissioner Section 33 …

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Illinois Compiled Statutes-215 ILCS 134/-Managed Care Reform …

WEB08/03/2023 Illinois Section 134/15 Provision of information See bold sections below: (a) A health care plan shall provide annually to enrollees and prospective enrollees, upon …

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Ohio Revised Code-Title XVII-Chapter 1751. Health Insuring …

WEBThe health insuring corporation shall not deny a claim for such a new service based solely on the fact that a prior authorization approval was not received for …

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Colorado Rev. Statutes-Title 10-Article 16-Part 1. General Provisions

WEB07/31/2023 Colorado Section 10-16-106.5 Prompt payment of claims–legislative declaration–rules See bold sections below: (1) The general assembly finds, determines, …

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Colorado Rev. Statutes-Title 10-Article 37. Contracts with Health …

WEB07/31/2023 Colorado Section 25-37-102 Definitions See bold sections below: As used in this article, unless the context otherwise requires: Participation in Products, Plans, or …

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III: Rental networks

WEBNonpayers to whom a health insurer may grant access include so-called “repricers,” “network brokers” or “rental network Preferred Provider Organizations (PPOs)” …

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Maryland Statutes-Article 15. Insurance

WEBInsurance - Managed Care Contracting. Maryland Statutes-Article 15. Insurance. Requirements applicable to medical necessity decisions made by private …

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New Mexico Admin. Code-Title 13-Chapter 10. Part 22. Managed …

WEB07/21/2020 New Mexico Section 13.10.22.8 Access to health care services This entire law falls under the category of “Network Adequacy.” See bold sections below that identify …

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California Code of Regulations-Title 28-Division 1-Chapter 2 …

WEB08/29/2023 California Section 1300.67.2.2 Timely Access to Non-Emergency Health Care Services and Annual Timely Access and Network Reporting Requirements 28 CCR § …

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The Laws Of New York-Consolidated Laws-Insurance. Article 48.

WEB08/16/2023 New York Section 4803 Health care professional applications and terminations See bold text below: Credentialing-Deadlines (a) (1) An insurer which offers a managed …

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Minnesota Statutes-Chapter 62M. Utilization Review of Health Care

WEB08/08/2023 Minnesota Section 62M.02 Definitions See bold text below: Subdivision 1. Terms. For the purposes of sections this chapter, the terms defined in this section have …

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The Laws Of New York-Consolidated Laws-Public Health-Article …

WEB04/06/2023 New York Section 4406-C Prohibitions See bold text below: 1. For purposes of this section, “health care plan” shall mean a health maintenance organization licensed …

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Arkansas Code-Title 23-Subtitle 3-Chapter 99-Subchapter 12.

WEB07/18/2023 Arkansas Section 23-99-1210 Healthcare contract or provider network — Prohibition (a) A healthcare insurer shall not: (1) Lease, rent, or sell a healthcare …

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Alabama State Board of Health Department of Public Health …

WEB07/27/2023 Alabama Section 420-5-6-.06 Assurance Of Access To And Continuity Of Care See bold text below: (1) A health maintenance organization shall have available …

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Rental Networks Archives

WEBAccess to health care services not to be sold, assigned, or granted access without express authorization — definitions — requirements. Rental Networks. State Law Arkansas Code …

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Code of Colorado Regs-3 CCR 702-4 Series 4-2

WEBN. “Mental health, behavioral health, and substance use disorder care providers” for the purposes of this regulation, and for the purposes of network adequacy …

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New Mexico Statutes Ann-Chapter 13-Article 7. Health Care …

WEB07/21/2020 New Mexico Section 13-7-18 Prescription drug coverage; step therapy protocols; clinical review criteria; exceptions This entire law falls under the category …

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Arkansas Code-Title 23-Subtitle 3-Chapter 99-Subchapter 11. Prior

WEB(3) A qualified health plan that is a health benefit plan under the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, and purchased on the Arkansas Health …

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The Insurance Company Law of 1921 (P.L.682, No.284)

WEBOne of the following: (1) A person, including a health care provider, to whom a covered person or enrollee has given express written consent to represent the covered …

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