§ 23-79-157. Payment for services rendered by physical therapists, occupational therapists, and speech-language pathologists
(a) As used in this section: (1) (A) “Health benefit plan” means any group or blanket plan, policy, or contract for healthcare services issued or delivered in this state by healthcare insurers, including indemnity and managed care plans and the plans providing health benefits to state and public school employees under § 21-5-401 et seq., […]
§ 23-79-158. Denials of dental claims
(a) (1) As used in this section, “insurer” means an insurance company, a health maintenance organization, a hospital and medical service corporation, or a self-insured health plan for employees of a governmental entity that provides dental benefits. (2) As used in this section, “insurer” includes an outside review entity that contracts with an insurance company, […]
§ 23-79-159. Notification of drug formulary changes
(a) (1) A health benefit plan that provides prescription drug coverage or contracts with a third party for prescription drug services with tiered copayments shall notify an enrollee presently taking a prescription drug, in writing or electronically at the request of the enrollee, at least sixty (60) days before an increase in the enrollee’s financial […]
§ 23-79-160. Health insurance information regarding Health Care Independence Program
Upon notification to enrollees in the Health Care Independence Program established by the Health Care Independence Act of 2013, § 20-77-2401 et seq. [repealed], that the Health Care Independence Program ends on December 31, 2016, the Department of Human Services shall simultaneously provide to enrollees in the Health Care Independence Program the following information in […]
§ 23-79-161. Payment for oral anticancer medications — Definitions
(a) As used in this section: (1) “Anticancer medication” means any drug or biologic that is used to kill, slow, or prevent the growth of cancerous cells; (2) (A) “Health benefit plan” means any group or blanket plan, policy, or contract for healthcare services issued, renewed, or extended in this state and outside this state […]
§ 23-79-162. Notice of renewal in affiliate or subsidiary
(a) This section applies to all forms of property and casualty insurance written under this subchapter. (b) A notice of nonrenewal is not required if: (1) The insured is transferred from an insurer to an affiliate insurer for future coverage; and (2) The transfer results in substantially similar or broader coverage to the insured. (c) […]
§ 23-79-163. Excepted benefits
Excepted benefits are not subject to the requirements of this subchapter regarding coverage of a specific person, provider, treatment, service, condition, or disease unless that coverage is required by law.
§ 23-79-148. Medical transportation services
(a) (1) Every insurance policy, other than a policy excluded pursuant to subsection (d) of this section, that provides specific coverage exclusively for medical transportation services, that is sold, delivered, issued for delivery, renewed, or offered for sale in this state by an insurer shall contain a provision providing for direct reimbursement to the provider […]
§ 23-79-149. Prescription drug benefits
(a) As used in this section, “insurance policy” means any individual, group, or blanket policy, contract, or evidence of coverage written, issued, amended, delivered, or renewed in this state, or which provides such insurance for residents of this state, by an insurance company, hospital medical corporation, or health maintenance organization. (b) No insurance company, hospital […]
§ 23-79-150. Healthcare plan — Health carrier — Definitions
(a) (1) (A) “Healthcare plan” means any individual, blanket, or group plan, policy, or contract for healthcare services issued or delivered by a carrier in this state, including indemnity and managed care plans. (B) “Healthcare plan” does not mean a plan that provides coverage only for: (i) A specified accident or accident-only coverage or long-term […]