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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.

To search for an exact phrase, you should enclose the entire phrase in quotation marks. For example, "patient care".
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Payment Issues

Network Issues

Contract Changes / Disputes

Coverage / Utilization Review

Claims Processing

State Law

California Code of Regulations Title 28-Managed Health Care Division 1-The Department of Managed Health Care Chapter 2-Health Care Service Plans Article 8. Self-Policing Procedures

05/08/2025 California Section 1300.71

Claims Settlement Practices

Amendments, Fee Schedules, OON-Payment Issues, Overpayments / Recoupments, Payment Edits, Payment Rules, Prompt Payment Deadlines, Retroactive Denial
State Law

Maryland Statutes-Article 15. Insurance

08/07/2023 Maryland Section 15-113

Health Insurance – Two–Sided Incentive Arrangements

Amendments, Fee Schedules, Overpayments / Recoupments, Participation in Products, Plans, or Networks, Payment Edits, Payment Rules, Prohibited financial incentives, Prompt Payment Deadlines, Risk—Physicians Taking
Ama Policy

Exclusion of Preoperative Services from Surgical Global Fee H-70.948

10/18/2019
Payment Rules
Ama Policy

Postoperative Care of Surgical Patients D-475.997

10/18/2019
Payment Rules
Ama Policy

Medicare Global Surgical Guidelines D-385.993

10/16/2019
Payment Rules
Ama Policy

Reimbursement for Diagnostic Studies Identified as Surgical Procedures H-390.977

10/15/2019
Payment Rules
Ama Policy

Non- Medicare Use of the RBRVS D-400.999

10/15/2019
Fee Schedules, Payment Edits, Payment Rules
Ama Policy

Assistants at Surgery H-385.969

10/14/2019
Payment Rules
Ama Policy

Requiring Third Party Reimbursement Methodology be Published for Physicians H-185.975

03/13/2019
Amendments, Fee Schedules, Payment Edits, Payment Rules, Rental Networks
State Law

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

05/12/2025 Texas Section 3.3703

Contracting Requirements

Amendments, Anti-gag clause, Continuity of Care Post-Contract, Fee Schedules, Liability-insurer shifting to physician, Payment Edits, Payment Rules, Profiling, Prohibited financial incentives, Prompt Payment Deadlines, Risk—Physicians Taking, Termination-Due Process