§ 9421. Pharmacy benefit management; registration; insurer audit of pharmacy benefit manager activities
§ 9421. Pharmacy benefit management; registration; insurer audit of pharmacy benefit manager activities (a) A pharmacy benefit manager shall not do business in this State without first registering with the Commissioner on a form and in a manner prescribed by the Commissioner. (b) In accordance with rules adopted by the Commissioner, pharmacy benefit managers operating […]
§ 9422. Credit card payments optional for providers
§ 9422. Credit card payments optional for providers (a) As used in this section: (1) “Credit card payment” means a type of electronic funds transfer in which a health insurer or its contracted vendor issues a single-use series of numbers associated with payment for health care services delivered by a health care provider and chargeable […]
§ 9431. Policy and purpose
§ 9431. Policy and purpose (a) It is declared to be the public policy of this State that the general welfare and protection of the lives, health, and property of the people of this State require that all new health care projects be offered or developed in a manner that avoids unnecessary duplication and contains […]
§ 9432. Definitions
§ 9432. Definitions As used in this subchapter: (1) “Ambulatory surgical center” means a facility or portion of a facility that provides surgical care not requiring an overnight stay. The office of a dentist in which activities are limited to dentistry and oral or maxillofacial surgical procedures shall not be deemed an ambulatory surgical center […]
§ 9418d. Contract amendments
§ 9418d. Contract amendments (a) A health care contract may be amended by mutual agreement of the parties. (b) Absent mutual agreement of the parties, a health care contract may be amended only as follows: (1) The contracting entity shall provide to the participating provider notice of the amendment and the amendment in writing not […]
§ 9418e. Most favored nation clauses prohibited
§ 9418e. Most favored nation clauses prohibited No later than 180 days after the effective date of this section, no contracting entity shall do any of the following: (1) offer to a provider, hospital, pharmacist, or pharmacy a health care contract that includes a most favored nation clause; (2) enter into a health care contract […]
§ 9418f. Rental network contracts
§ 9418f. Rental network contracts (a) Definitions. As used in this section: (1) “Health care services” means services for the diagnosis, prevention, treatment, or cure of a health condition, illness, injury, or disease. (2)(A) “Provider” means a physician, a physician organization, or a physician hospital organization that is acting exclusively as an administrator on behalf […]
§ 9418g. Enforcement
§ 9418g. Enforcement In addition to any other remedy provided by law, the Commissioner may, in his or her sole discretion, enforce the provisions of this subchapter as specified in this section. In determining whether to undertake an enforcement action, the Commissioner may consider the relative resources of the complaining party and the alleged noncompliant […]
§ 9419. Charges for access to medical records
§ 9419. Charges for access to medical records (a) A custodian may impose a charge that is no more than a flat $5.00 fee or no more than $0.50 per page, whichever is greater, for providing copies of an individual’s health care record. A custodian shall provide an individual or the authorized recipient with an […]
§ 9417. Tax-advantaged accounts for health-related expenses; administration; rulemaking
§ 9417. Tax-advantaged accounts for health-related expenses; administration; rulemaking (a) As used in this section: (1) “Flexible spending account” or “FSA” has the same meaning as in 26 U.S.C. § 106(c)(2). (2) “Health reimbursement arrangement” or “HRA” means any account-based reimbursement arrangement funded solely by employer contributions that reimburses an employee, spouse, or dependents, or […]