
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.
Payment of Certain Out-of-Network Claims
Definitions; Methodology for Calculation of Average Contracted Rate; Reporting
Fast, Fair and Cost-Effective Dispute Resolution Mechanism
Methodology for Determining Average Contracted Rate; Default Reimbursement Rate
Claims Settlement Practices
Definitions; Balance Billing in Cases of Emergency Services; Balance Billing in Cases of Non-emergency Services Performed by Nonparticipating Providers at Certain Participating Health Care Facilities; Dispute Resolution Regarding the Fair Value of Health Care Items or Services
Findings—Intent—2019 c 427; Short title; Definitions; Dispute resolution process—Determination of commercially reasonable payment amount; Requirement to provide certain information on website or upon consumer request—Requirement to provide carriers with nonemployed provider lists; Health care provider—Requirement to provide certain information on website or upon consumer request—Requirement to submit network status information to carriers; Carrier—Requirement to update website and provider directory—Requirement to provide enrollee with certain information; Application of chapter to self-funded group health plans that elect to participate in balance billing protection provisions—Annual notice to commissioner; Determining the adequacy of provider networks—Required considerations; Allowed amounts paid to nonparticipating providers; Application of state and federal requirements—Applicability information access—Waivers prohibited
Concerning Gag Clauses in Individual and Group Health Benefit Plans