Risk-Physicians Taking-Med. Adv. Archives

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.

Payment Issues

Network Issues

Contract Changes / Disputes

Coverage / Utilization Review

Claims Processing

State Law

Arkansas Code-Title 23-Subtitle 3-Chapter 99-Subchapter 9. Limitation on Financial Penalties in Alternative Payment Systems

07/28/2023 Arkansas Section 23-99-904

Waiver prohibited

Risk-Physicians Taking-Med. Adv.

Federal Law

Title 42-Chapter 7-Subchapter XVIII-Part C. Medicare+Choice Program

11/21/2024 42 USC Section 1395w-22

Benefits and beneficiary protections

Anti-gag clause-Med. Adv., Directories-Med. Adv., Liability-insurer shifting to physician-Med. Adv., Med. Adv.-Med. Nec. Appeals-Deadlines, Med. Adv.-Med. Nec. Decisions-Deadlines, Network Adequacy-Med. Adv., Prohibited financial incentives-Med. Adv., Risk-Physicians Taking-Med. Adv.

Federal Law

Title 42-Chapter IV-Subchapter B-Part 422-Subpart E. Relationships with Providers

11/21/2024 42 CFR Section 422.208

Physician incentive plans: requirements and limitations

Prohibited financial incentives-Med. Adv., Risk-Physicians Taking-Med. Adv.

Federal Law

Title 42-Chapter IV-Subchapter B-Part 422-Subpart H. Provider-Sponsored Organizations

11/18/2024 Sections 42 CFR 422.352, 422.354, 422.356 and 422.378

Basic requirements; Requirements for affiliated providers; Determining substantial financial risk and majority financial interest; Relationship to State law.

Preemption-Medicare Advantage, Risk-Physicians Taking-Med. Adv.

Federal Law

Title 42-Chapter IV-Subchapter B-Part 417-Subpart L. Medicare Contract Requirements

11/18/2024 42 CFR Section 417.479

Requirements for physician incentive plans

Prohibited financial incentives-Med. Adv., Risk-Physicians Taking-Med. Adv.