20-837. Tax exemption; exceptions A. Every corporation doing business pursuant to this article is declared to be a nonprofit and benevolent institution and to be exempt from state, county, district, municipal and school taxes, including the taxes prescribed by this title, and excepting only the fees prescribed by section 20-167 and taxes on real and […]
20-838. Subscribers and employees exempt from corporate indebtedness The private property of the subscribers, agents, officers, directors, members and employees of any corporation holding a certificate of authority under this article shall be wholly exempt from any of the debts, obligations and liabilities of the corporation.
20-839. Exemption of certain hospital plans A. This article shall not apply to any corporation operating or maintaining a hospital service plan, medical service plan, dental service plan or optometric service plan, participation in which is limited to its employees and the employees of other persons or corporations with which such corporation may have contracted […]
20-840. Continuation of existing certificates, licenses and rights This article shall not be construed in any manner to abrogate, amend or annul any certificate, license or right acquired prior to January 1, 1955 by any corporation, insurer, hospital, physician, dentist, optometrist, individual or subscriber under or pursuant to Laws 1945, 1st special session, chapter 13, […]
20-841. Prohibiting denial of certain contract benefits A. Notwithstanding any provision of any subscription contract of a hospital and medical service corporation, benefits shall not be denied under the contract for any medical or surgical service performed by a holder of a license issued pursuant to title 32, chapter 7 or 11, if the service […]
20-841.01. Prohibiting denial of chiropractic contract benefits; direct reimbursement If a subscription contract of a hospital and medical service corporation provides for or offers reimbursement for any service which is within the lawful scope of the practice of a chiropractor holding a certificate or license issued by the state in which the services are rendered, […]
20-841.02. Prohibiting denial of psychologist contract benefits If a subscription contract of a hospital and medical service corporation provides for or offers reimbursement for any service which is within the lawful scope of the practice of a psychologist holding a certificate or license issued by the state in which the services are rendered, a subscriber […]
20-841.03. Prohibiting denial of contract benefits; nurses; reimbursement If a subscription contract of a hospital and medical service corporation provides or offers reimbursement for any service which is within the scope of the practice of a registered nurse practitioner or a certified registered nurse qualified under the rules adopted by the state board of nursing […]
20-841.04. Standing referrals to network health care professionals; definition A. Any corporation that offers a health benefits plan shall establish a procedure by which a subscriber may apply for a standing referral to a network health care professional. The corporation shall provide a subscriber with a standing referral if all of the following conditions are […]
20-841.05. Prescription drug formulary; definitions A. A corporation with a prescription drug benefit that uses a drug formulary as a component of the subscription contract shall provide to its subscribers notice in the contract and any disclosure form regarding the applicable drug formulary. The corporation shall write the notice so that the language and format […]
20-841.06. Continuity of care; definition A. Any corporation that offers a health benefits plan shall allow any new subscriber whose health care provider is not a member of the provider network, on written request of the subscriber to the corporation, to continue an active course of treatment with that health care provider during a transitional […]
20-841.07. Medical supplies Any corporation that provides coverage for medical supplies shall provide coverage for those medical supplies through one or more participating vendors who are reasonably accessible to subscribers as determined by the department in terms of hours of service and areas of coverage within the geographic service area of the health care plan.
20-841.08. Prohibiting denial of occupational or physical therapist contract benefits If a hospital service corporation or medical service corporation subscription contract provides coverage for occupational or physical therapy services, and provides both an in-network and out-of-network benefit, a service corporation shall not deny a claim for covered occupational or physical therapy services obtained out-of-network solely […]
20-841.09. Telehealth; coverage of health care services; definition A. All contracts issued, delivered or renewed in this state must provide coverage for health care services that are provided through telehealth if the health care service would be covered were it provided through an in-person encounter between the subscriber and a health care provider and provided […]
20-841.10. Cancer treatment medications; cost sharing; definition A. A contract that is issued, delivered or renewed by a corporation on or after January 1, 2016 and that provides coverage both for cancer treatment medications that are injected or intravenously administered by a health care provider and for patient-administered cancer treatment medications, including medications that are […]
20-841.11. Prescription eyedrops; refills A. Beginning January 1, 2018, any contract that is issued, delivered or renewed by a corporation and that provides coverage for prescription eyedrops to treat glaucoma or ocular hypertension may not deny coverage for a refill of a prescription for eyedrops to treat glaucoma or ocular hypertension if all of the […]
20-841.12. Coverage of health care services All contracts issued, delivered or renewed on or after July 1, 2017 by a corporation in this state must provide coverage for lawful health care services that are provided by a health care provider to a subscriber regardless of the familial relationship of the health care provider to the […]
20-841.13. Biomarker testing; coverage; definitions A. A hospital service corporation or medical service corporation that issues, amends, delivers or renews a subscription contract on or after January 1, 2023 shall provide coverage for biomarker testing. B. A subscription contract shall cover biomarker testing for the purposes of diagnosis, treatment, appropriate management or ongoing monitoring of […]
20-842. Prohibition against excluding coverage because of previous tests for a condition An insurance contract offered by a hospital, medical, dental or optometric service corporation shall not exclude coverage of a condition if the insured person has previously had tests for the condition and the condition was not found to exist. There must be evidence […]
20-843. Eligibility; prohibiting cancellation because of eligibility for certain benefits A. Except as specifically provided in sections 20-1379 and 20-1380, with respect to the determination of whether a person is an eligible individual, a hospital and medical service corporation shall not consider the availability of or a person’s eligibility for medical assistance pursuant to title […]
