The Legislature of the Virgin Islands believes that many residents of the Virgin Islands who are covered by a recognized health insurance plan are nevertheless prevented from enjoying the benefits of such a plan by the high up-front cost of obtaining healthcare, and the prospect of having to wait for a reimbursement of those costs. […]
(a) “Commissioner” means the Commissioner of Insurance. (b) “Health care provider” means a person, corporation, facility or institution who must be licensed by this territory to provide health care or professional medical services including but not limited to any physician, osteopath, hospital, dentist, registered or licensed practical nurse, optometrist, podiatrist, physical therapist, psychologist, chiropractor, par-medical […]
(a) No health insurance plan, upon passage of this act, shall be issued, delivered or used unless it has been filed with and approved by the Commissioner. The health insurance for employees of the Government of the Virgin Islands and any group health insurance plan contracted by any semi-autonomous agency or instrumentality of the Government […]
(a) If a patient, at the time of requesting health care services, presents to the health care provider evidence of coverage by a recognized health insurer, then the health care provider shall apply the following procedure when requiring payment for any services rendered: (1) The health care provider may require payment at or before the […]
(a) Any insurer providing health insurance coverage shall be required to process and pay any uncontested claim, within thirty (30) calendar days from the date of receiving the claim. (b) If there is a contested claim, the insurer shall, within the same thirty (30) day calendar period notify the health care provider of its decision […]
(a) Each insurer providing coverage under a health insurance plan shall establish and maintain an accessible information service which health care providers may contact telephonically and electronically to ascertain immediately whether a patient, service or procedure is covered under the plan, and whether a patient has satisfied any deductible amounts under the plan. The health […]
(a) Any health care provider or recognized health insurer who willfully violate the provisions of this chapter shall be subject to the following penalties: (1) A health care provider or recognized health insurer who intentionally or negligently fails to comply with the provisions of this chapter shall be fined by the Commissioner not less than […]
(a) Notwithstanding the provisions of this chapter, any physician who is a member of a Preferred Provider Organization (“PPO”) which meets, the requirements set forth below, shall not be subject to the requirements of section 1724 of this title: (1) The PPO physician shall require no more than a reasonable co- payment by the patient […]
