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

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

Postoperative Care of Surgical Patients D-475.997

Payment Rules
Ama Policy

Medicare Global Surgical Guidelines D-385.993

Payment Rules
Ama Policy

Non- Medicare Use of the RBRVS D-400.999

Fee Schedules, Payment Edits, Payment Rules
Ama Policy

Assistants at Surgery H-385.969

Payment Rules
ARC Advocacy Resources

Fee Schedule/Taking Risk Disclosure Model Bill

Ensures that payers give physicians complete and accurate information concerning fee for services reimbursement, as well as a wide variety of risk arrangements, e.g., capitation, to make sure that physicians are fully anticipate expected revenue as well as be empowered to managed successfully any risk they have assumed.

Fee Schedules, Model Legislation, Payment Edits, Payment Rules, Risk—Physicians Taking
Ama Policy

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

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

08/24/2023 Texas Section 3.3703

Contracting Requirements

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