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Ama Policy

Most Favored Nation Clause within Insurance Contracts H-385.938

03/13/2019
Most Favored Nation
State Law

Alaska Statutes-Title 21-Chapter 07. Patient Protections Under Health Care Insurance Policies

07/27/2023 Alaska Section 21.07.010

Patient and health care provider protection

Anti-gag clause, Anti-retaliation, Fee Schedules, Liability-insurer shifting to physician, Most Favored Nation, Participation in Products, Plans, or Networks, Prohibited financial incentives, Termination
State Law

Arkansas Code-Title 23-Subtitle 3-Chapter 99-Subchapter 12. Healthcare Contracting Simplification Act

07/18/2023 Arkansas Sections 23-99-1202

Definitions

Amendments, Most Favored Nation, Participation in Products, Plans, or Networks
State Law

Arkansas Code-Title 23-Subtitle 3-Chapter 99-Subchapter 12. Healthcare Contracting Simplification Act

07/28/2023 Arkansas Section 23-99-1204

Prohibition-Most favored nation clause

Most Favored Nation
State Law

Health and Safety Code-Division 2-Chapter 2.2. Health Care Service Plans-Article 5. Standards

07/28/2023 California Section 1371.2

No overpayment request solely because of contract with another health care service plan

Most Favored Nation, Overpayments / Recoupments
State Law

Health and Safety Code-Division 2-Chapter 2.2. Health Care Service Plans-Article 5. Standards

07/28/2023 California Section 1371.22

Limitation on most favored nation clauses

Most Favored Nation
State Law

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

07/29/2023 Connecticut Section 38a-479b

Material changes to fee schedules. Return of payment by provider. Appeals. Filing of claim by provider under other applicable insurance coverage. Certain clauses, covenants and agreements prohibited. Exception

Amendments, Claims Filing Deadlines, Fee Schedules, Most Favored Nation, Overpayments / Recoupments, Participation in Products, Plans, or Networks, Termination
State Law

Title 41. Insurance-Chapter 34. Hospital and Professional Service Corporations

08/02/2023 Idaho Section 41-3443

Best price–Most favored nations clause prohibited

Most Favored Nation
State Law

Title 41. Insurance-Chapter 39. Managed Care Reform

08/02/2023 Idaho Section 41-3927

Health care providers–Participation by any qualified, willing provider–Contracts–Grievance procedure

Anti-gag clause, Liability-insurer shifting to physician, Most Favored Nation, Termination
State Law

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

12/19/2024 Indiana Sections 27-8-11-1, 27-8-11-4.5, 27-8-11-7, 27-8-11-8, 27-8-11-9, 27-8-11-11, 27-8-11-13

Definitions; Permitted Disclosures by Providers; Coverage of Benefit or Service; Payment of Provider, Application; Provider Credentialing; Provider Directories; Preferred Provider Agreement Prohibitions; Insurer Payment to Insured for Service Rendered by Noncontracted Provider; Requirements; Fully Credentialed Provider Reimbursement; Requirements

Anti-gag clause, Anti-retaliation, Credentialing-Deadlines, Credentialing-Payment Issues, Directories, Most Favored Nation