§ 58-3-265. Prohibition on managed care provider incentives.
§ 58‑3‑265. Prohibition on managed care provider incentives.
An insurer offering a healthbenefit plan may not offer or pay any type of material inducement, bonus, orother financial incentive to a participating provider to deny, reduce,withhold, limit, or delay specific medically necessary and appropriate healthcare services covered under the health benefit plan to a specific insured orenrollee. This section does not prohibit insurers from paying a provider on acapitated basis or withholding payment or paying a bonus based on the aggregateservices rendered by the provider or the insurer's financial performance. (2001‑446, s. 1.8.)