Search Results

Ama Policy

Qualifications and Credentialing of Physicians Involved in Managed Care H-285.991

03/13/2019
Credentialing-Due Process-Denial of Contract, Termination, Termination-Due Process
Ama Policy

Managed Care Consensus Bill H-285.941

03/13/2019
Credentialing-Due Process-Denial of Contract, Termination-Due Process
ARC Advocacy Resources

Termination Protection Model Bill

Requires a health insurer to give a physician specific fair process rights, e.g., a hearing, before either officially denying the physician’s request to join an insurer’s network or terminating a physician’s managed care contract or network participation.

Model Legislation, Termination-Due Process
Ama Policy

AMA Principles for Physician Employment H-225.950

10/14/2019
Anti-retaliation, Restrictive Covenants, Termination, Termination-Due Process
State Law

Title 18. Insurance Code-Chapter 33. Health Insurance Contracts-Subchapter I. General Provisions

06/22/2020 Delaware Section 3339

Refusal to contract

Anti-retaliation, Profiling, Termination, Termination-Due Process
State Law

Title XXXVII-Insurance-Chapter 641-Part I. Health Maintenance Organizations

06/23/2020 Florida Section 641.315

Provider contracts

Amendments, Anti-gag clause, Fee Schedules, Participation in Products, Plans, or Networks, Termination, Termination-Due Process
State Law

Indiana Code-Title 27-Article 8-Chapter 11-Accident and Sickness Insurance─Reimbursement Agreements

03/19/2021 Indiana Section 27-8-11-3

Reimbursement agreements; immunity

Termination-Due Process
State Law

KY. Rev. Statutes-Chapter 304-Subtitle 17A-Health Benefit Plans-Managed Care Plans

07/01/2020 Kentucky Section 304.17A-525

Standards for provider participation; Mechanisms for consideration of provider applications; Policy for removal or withdrawal

Credentialing-Patient Demographics, Profiling, Termination, Termination-Due Process
State Law

KY. Rev. Statutes-Chapter 304-Subtitle 17A-Health Benefit Plans-Miscellaneous Provisions

07/01/2020 Kentucky Section 304.17A-254

Duties of insurer offering health benefit plan

Amendments, Anti-gag clause, Anti-retaliation, Directories, Fee Schedules, Termination, Termination-Due Process
State Law

Maine Rev. Statutes-Title 24-A, Chapter 56-A, Subchapter 1. Health Plan Requirements

09/17/2021 Maine Section 4303

Plan requirements

Amendments, Anti-gag clause, Anti-retaliation, Continuity of Care Post-Contract, Credentialing-Deadlines, Credentialing-Due Process-Denial of Contract, Credentialing-Payment Issues, Fee Schedules, Most Favored Nation, Overpayments / Recoupments, Participation in Products, Plans, or Networks, Prohibited financial incentives, Retroactive Denial, Termination, Termination-Due Process