Missouri Laws 376.1065 – Official notification communications, contracting entity requirements
1. As used in this section, the following terms shall mean:
(1) “Contracting entity”, any health carrier, as such term is defined in section 376.1350, subject to the jurisdiction of the department engaged in the act of contracting with providers for the delivery of dental services, or the selling or assigning of dental network plans to other entities under the jurisdiction of the department;
Terms Used In Missouri Laws 376.1065
- Department: the department of commerce and insurance. See Missouri Laws 376.005
- following: when used by way of reference to any section of the statutes, mean the section next preceding or next following that in which the reference is made, unless some other section is expressly designated in the reference. See Missouri Laws 1.020
- Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
- person: may extend and be applied to bodies politic and corporate, and to partnerships and other unincorporated associations. See Missouri Laws 1.020
(2) “Department”, the department of commerce and insurance;
(3) “Official notification”, written communication by a provider or participating provider to a contracting entity describing such provider’s or participating provider’s change in contact information or participation status with the contracting entity;
(4) “Participating provider”, a provider who has an agreement with a contracting entity to provide dental services with an expectation of receiving payment, other than coinsurance, co-payments, or deductibles, directly or indirectly from such contracting entity;
(5) “Provider”, any person licensed under chapter 332.
2. A contracting entity shall, upon official notification, make changes contained in the official notification to their electronic provider material and their next edition of paper material made available to plan members or other potential plan members.
3. The department, when determining the result of a market conduct examination under sections 374.202 to 374.207, shall consider violations of this section by a contracting entity.