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§ 687B.600 |
Definitions |
§ 687B.602 |
‘Administrator’ defined |
§ 687B.605 |
‘Covered person’ defined |
§ 687B.606 |
‘Dental care’ defined |
§ 687B.607 |
‘Direct notification’ defined |
§ 687B.610 |
‘Evidence of coverage’ defined |
§ 687B.615 |
‘Health benefit plan’ defined |
§ 687B.620 |
‘Health care services’ defined |
§ 687B.625 |
‘Health carrier’ defined |
§ 687B.630 |
‘Intermediary’ defined |
§ 687B.635 |
‘Medically necessary’ defined |
§ 687B.640 |
‘Network’ defined |
§ 687B.645 |
‘Network plan’ defined |
§ 687B.650 |
‘Participating provider of health care’ defined |
§ 687B.655 |
‘Primary care physician’ defined |
§ 687B.658 |
‘Provider network contract’ defined |
§ 687B.660 |
‘Provider of health care’ defined |
§ 687B.664 |
‘Third party’ defined |
§ 687B.665 |
‘Utilization review’ defined |
§ 687B.670 |
Requirements to offer or issue network plan |
§ 687B.675 |
Provision of information to Office for Consumer Health Assistance |
§ 687B.680 |
Health carrier required to establish mechanism for ongoing notification of participating providers of health care of services covered by network plan and for which provider is responsible |
§ 687B.690 |
Required provisions in contract between participating provider of health care and health carrier |
§ 687B.693 |
Access to services and contractual discounts of a provider of health care: Inapplicability of provisions |
§ 687B.694 |
Access to services and contractual discounts of a provider of health care: Requirements for granting access; termination; confidentiality |
§ 687B.695 |
Access to services and contractual discounts of a provider of health care: Obligations of third party that grants access to another third party |
§ 687B.696 |
Access to services and contractual discounts of a provider of health care: Information required to be provided to health carrier and providers of health care by third parties; update of information |
§ 687B.697 |
Access to services and contractual discounts of a provider of health care: Obligations of health carrier and third parties concerning remittance advice or explanation of payment; refusal of discount taken on such advice or explanation by provider |
§ 687B.700 |
Contract required to provide requirement that participating provider of health care continue delivery of services if health carrier or intermediary insolvent or ceases operations for specified period; billing of covered person |
§ 687B.710 |
Certain provisions included in contract required to be construed in favor of covered person, survive termination of contract and supersede certain contrary agreements |
§ 687B.720 |
Contract required to provide for notice of insolvency or cessation of operations of health carrier or intermediary to participating provider of health care |
§ 687B.723 |
Claim for dental care: Health carrier or administrator of health benefit plan prohibited from denying claim for which prior authorization has been granted; exceptions |
§ 687B.725 |
Claim for dental care: Requirements and limitations related to recovery of overpayments |
§ 687B.730 |
Health carrier required to notify participating provider of health care of administrative policies and programs of carrier |
§ 687B.740 |
Inducement to provide less than medically necessary health care services prohibited |
§ 687B.750 |
Health carrier not to prohibit certain actions by participating provider of health care |
§ 687B.760 |
Health records; confidentiality |
§ 687B.770 |
Assignment or delegation of rights and responsibilities without prior written consent prohibited |
§ 687B.780 |
Health carrier required to ensure that participating providers of health care furnish covered services to all covered persons; exception |
§ 687B.790 |
Health carrier required to notify participating providers of health care of obligation to collect coinsurance, copayment or deductible or notify covered person of obligation for services not covered |
§ 687B.800 |
Retaliation for good faith reporting to state or federal authority prohibited |
§ 687B.810 |
Health carrier required to establish mechanism to allow participating provider of health care to determine whether a person is a covered person or within grace period for payment of premium |
§ 687B.820 |
Procedures for resolution of disputes |
§ 687B.830 |
Contract for purposes of network plan prohibited from conflicting with network plan or law; notice of provisions and incorporated documents; notice of changes |
§ 687B.840 |
Health carrier required to inform participating provider of health care of status and inclusion on certain lists maintained by health carrier upon request or change in such status or inclusion |
§ 687B.850 |
Regulations |