Search Results

State Law

California Code of Regulations-Title 10-Chapter 5-Subchapter 2-Article 6. Provider Network Access Standards for Disability Policies and Agreements

07/28/2023 California Section 2240.1

Adequacy and Accessibility of Provider Services

Credentialing-Patient Demographics, Network Adequacy
State Law

General Statutes of Connecticut-Title 38a-Chapter 700c. Health Insurance

07/16/2023 Connecticut Section 38a-472f

Network adequacy. Health carrier duties and responsibilities. Access plan filing.

Anti-gag clause, Anti-retaliation, Continuity of Care Post-Contract, Credentialing-Patient Demographics, Network Adequacy, Participation in Products, Plans, or Networks, Profiling, Prohibited financial incentives, Termination
State Law

Title 18 Insurance-1400-1403 Managed Care Organizations

08/01/2023 Delaware Section 1403-11.0

Quality Assurance and Operations

Credentialing-Patient Demographics, Network Adequacy, Retroactive Denial, U.R. Criteria
State Law

Hawaiʻi Revised Statutes-Title 24-Chapter 431-Insurance Code

08/02/2023 Hawaii Section 431:26-104

Requirements for health carriers and participating providers

Amendments, Anti-gag clause, Anti-retaliation, Continuity of Care Post-Contract, Credentialing-Patient Demographics, Profiling, Termination
State Law

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

08/05/2023 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

Miss. Admin. Code-Title 19-Part 3-Chapter 14-Managed Care Plan Network Adequacy

07/10/2020 Mississippi Sections 14.01-14.13

Managed care plan network adequacy

Anti-gag clause, Anti-retaliation, Credentialing-Patient Demographics, Fee Schedules, Liability-insurer shifting to physician, Network Adequacy, Prohibited financial incentives, Termination
State Law

Missouri Statutes-Title XXIII-Chapter 354. Health Services Corps/HMOs/Prepaid Dental Plans–Community-Based HMOs

08/09/2023 Missouri Section 354.606

Providers notified of specific covered services, when — hold harmless provision — cessation of operations procedure — selection standards for health care professionals, filing with the department.

Anti-gag clause, Anti-retaliation, Credentialing-Patient Demographics, Prohibited financial incentives
State Law

Montana Code Ann-Title 33-Chapter 36-Part 2. Network Adequacy

08/10/2023 Montana Section 33-36-203

Selection of providers-professional credentials standards

Credentialing-Patient Demographics
State Law

Nebraska Rev. Statutes-Chapter 44. Insurance

08/10/2023 Nebraska Section 44-4109.01

Policies or contracts; requirements

Credentialing-Due Process-Denial of Contract, Credentialing-Patient Demographics, Termination-Due Process
State Law

North Carolina Gen. Statutes-Chapter 58-Article 3. General Regulations for Insurance

08/13/2023 North Carolina Section 58-3-200

Miscellaneous insurance and managed care coverage and network provisions

Credentialing-Patient Demographics, Medical Necessity-Definition, Retroactive Denial