§ 23-17.18-1 - Modification of health plans.
SECTION 23-17.18-1
§ 23-17.18-1 Modification of health plans.– (a) A health plan may materially modify the terms of a participating agreementit maintains with a physician only if the plan disseminates in writing by mailto the physician the contents of the proposed modification and an explanation,in nontechnical terms, of the modification's impact.
(b) The health plan shall provide the physician anopportunity to amend or terminate the physician contract with the health planwithin sixty (60) days of receipt of the notice of modification. Anytermination of a physician contract made pursuant to this section shall beeffective fifteen (15) calendar days from the mailing of the notice oftermination in writing by mail to the health plan. The termination shall notaffect the method of payment or reduce the amount of reimbursement to thephysician by the health plan for any patient in active treatment for an acutemedical condition at the time the patient's physician terminates his, her, orits physician contract with the health plan until the active treatment isconcluded or, if earlier, one year after the termination; and, with respect tothe patient, during the active treatment period the physician shall be subjectto all the terms and conditions of the terminated physician contract, includingbut not limited to, all reimbursement provisions which limit the patient'sliability.
(c) Nothing in this section shall apply to accident-only,specified disease, hospital indemnity, Medicare supplement, long-term care,disability income, or other limited benefit health insurance policies.