§ 27-20.10-2 - Scope.
SECTION 27-20.10-2
§ 27-20.10-2 Scope. – (a) This chapter shall apply to health insurance corporations subject tochapter 1 of this title, nonprofit hospital or medical service corporationssubject to chapters 19 or 20 of this title, and health maintenance organizationincorporated or resident in the state of Rhode Island.
(b) This chapter shall not apply to provider networkcontracts for services provided to Medicaid, Medicare or state children'shealth insurance program (SCHIP) beneficiaries.
(c) This chapter shall not apply in circumstances whereaccess to the provider network contract is granted to an entity operating undercommon control with or under the same brand licensee program as the contractingentity ("affiliate entities"). Contracting entities shall, however, make thelist of such affiliate entities available on a website or by other means. Theaffiliate entities shall have the same rights and responsibilities under theprovider network contracts as the contracting entities.
(d) This chapter shall not apply to a contract between acontracting entity and a discount medical plan organization.
(e) This chapter shall not apply to any entity, such asemployers, church plans or government plans, receiving administrative servicesfrom the contracting entity or an affiliate entity. Such exempt entities shallhave the same rights and responsibilities under the provider network contractsas the contracting entities, except the exempt entities shall not grant accessto a provider's health care services and contractual discounts to any otherentity.