State Laws

Search state statutes and regulations in all 50 states and the District of Columbia to find out what rights you have in your state and what other states are doing to empower physicians and patients in the face of health insurer market power.

State Law

Rhode Island Gen Laws-Title 27-Chapter 27-18.8. Health Care Accessibility and Quality Assurance Act

08/22/2023 Rhode Island Section 27-18.8-3

Certification of network plans

Anti-retaliation, Continuity of Care Post-Contract, Credentialing-Patient Demographics, Directories, Most Favored Nation, Termination
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

Texas Admin. Code-Title 28-Part 1-Chapter 3-Subchapter X-Division 1. General Requirements

08/24/2023 Texas Section 3.3706

Designation as a Preferred Provider, Decision to Withhold Designation, Termination of a Preferred Provider, Review of Process

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

Virginia Admin Code-Title 12-Agency 5-Chapter 408. Certificate of Quality Assurance of Managed Care Health Insurance Plan Licensees

08/26/2023 Virginia Section 5-408-170

Provider Credentialing and Recredentialing

Credentialing-Deadlines, Credentialing-Patient Demographics, Credentialing-Payment Issues, Termination-Due Process
State Law

State of Vermont-Dept. of Financial Regulation-Rule H-2009-03

08/26/2023 Vermont Reg. H-2009-03

Consumer protection and quality requirements for managed care organizations

Amendments, Anti-gag clause, Anti-retaliation, Continuity of Care Post-Contract, Credentialing-Due Process-Denial of Contract, Credentialing-Patient Demographics, Directories, ERISA-Med. Nec. Decisions-Deadlines, Liability-insurer shifting to physician, Medical Necessity-Definition, Network Adequacy, OON-Payment Issues, Prohibited financial incentives, Retroactive Denial, State Medical Necessity Appeals-Deadlines, Termination, Termination-Due Process, U.R. Criteria
State Law

Washington Admin Code-Title 284-Chapter 284-170-Subchapter C. Provider Contracts and Payment

08/28/2023 Washington Section 284-170-411

Selection of participating providers-Credentialing and unfair discrimination

Credentialing-Patient Demographics
State Law

Rhode Island Code of Regs-Title 230-Chapter 20-Subchapter 30-Part 9. Network Plans

08/22/2023 Rhode Island Part 9. Network Plans

Network plans

Amendments, Anti-retaliation, Continuity of Care Post-Contract, Credentialing-Deadlines, Credentialing-Patient Demographics, Credentialing-Payment Issues, Directories, Most Favored Nation, Network Adequacy, Profiling, Termination
State Law

Oklahoma Statutes. Title 36. Insurance

08/18/2023 Oklahoma Section 6907

Reasonable standards of quality of care – Quality assurance plan and activities – Record of proceedings – Patient record system – Medical policy – Credentialing and recredentialing of health care providers – Termination or nonrenewal of contracts – Emergency services

Anti-gag clause, Credentialing-Deadlines, Credentialing-Patient Demographics, 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

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