§ 33-20D-1. Definitions
As used in this chapter, the term: “Affiliate” means an entity owned or controlled, either directly or through a parent or subsidiary entity, by a contracting entity that accesses the rates, terms, or conditions of health care services. “Contracting entity” means any person or entity that enters into direct contracts with health care providers for […]
§ 33-20D-2. Registration With Commissioner; Requirements; Fee; Approved List
Any person who commences business as a rental preferred provider network shall register with the Commissioner within 30 days of commencing business in this state unless such person is licensed by the Commissioner as a health insurer. Each rental preferred provider network not licensed by the Commissioner on July 1, 2016, shall be required to […]
§ 33-20D-3. Prohibited Activities; Confidentiality Agreements
A rental preferred provider network shall not: Knowingly access or utilize a network provider’s contractual discount pursuant to a provider network contract without a contractual relationship with the network provider, rental preferred provider network, or third party; or Lease, rent, or otherwise grant to a third party access to a provider network contract unless: The […]
§ 33-20D-4. Rights and Responsibilities Imposed on Third Parties
A third party, having itself been granted access to a network provider’s health care services and contractual discounts pursuant to a provider network contract, that subsequently grants access to another third party shall be obligated to comply with the rights and responsibilities imposed on contracting entities pursuant to this chapter. A third party that enters […]
§ 33-20D-5. Exclusions
This chapter shall not apply to: Provider network contracts for services provided to Medicaid, medicare, the state health benefit plan under Article 1 of Chapter 18 of Title 45, or State Children’s Health Insurance Program (SCHIP) beneficiaries; Employers, church plans, or government plans receiving administrative services from a rental preferred provider network or its affiliates, […]
§ 33-20D-6. Penalties
Any person or entity that is not duly licensed or that should be licensed by the department or that is not duly registered or that should be registered with the department pursuant to Code Section 33-20D-2 and acts as a rental preferred provider network, as defined in paragraph (7) of Code Section 33-20D-1, shall be […]