Section 27-20.9-1. – Health care contracts — Required provisions — Definitions.
§ 27-20.9-1. Health care contracts — Required provisions — Definitions. (a) On and after January 1, 2008, a health insurer that contracts with a health care provider shall comply with the provisions of this chapter and shall include the provisions required by this chapter in the health care contract. A contract in existence prior to […]
Section 27-20.9-2. – Credentialing — Insurers shall notify providers of initial credentialing within ten business days of approval by the insurer credentialing committee.
§ 27-20.9-2. Credentialing — Insurers shall notify providers of initial credentialing within ten business days of approval by the insurer credentialing committee. The health insurer shall reimburse the health care provider for covered services rendered by the health care provider to the health insurer’s subscribers or members following the first business day after the credentialing […]
Section 27-20.9-3. – Pay-for-performance guidelines.
§ 27-20.9-3. Pay-for-performance guidelines. A health insurer shall not require a physician, as a condition of contracting, to participate in any financial or reimbursement incentive program, commonly referred to as pay-for-performance programs unless such program meets the principles and guidelines for pay-for-performance programs endorsed by the national quality forum and adopted by the AQA Alliance […]