TITLE 27

Insurance

CHAPTER 27-20.10

Rental Network Contract Arrangements

SECTION 27-20.10-2



   § 27-20.10-2  Scope. –

(a) This chapter shall apply to health insurance corporations subject to

chapter 1 of this title, nonprofit hospital or medical service corporations

subject to chapters 19 or 20 of this title, and health maintenance organization

incorporated or resident in the state of Rhode Island.



   (b) This chapter shall not apply to provider network

contracts for services provided to Medicaid, Medicare or state children's

health insurance program (SCHIP) beneficiaries.



   (c) This chapter shall not apply in circumstances where

access to the provider network contract is granted to an entity operating under

common control with or under the same brand licensee program as the contracting

entity ("affiliate entities"). Contracting entities shall, however, make the

list of such affiliate entities available on a website or by other means. The

affiliate entities shall have the same rights and responsibilities under the

provider network contracts as the contracting entities.



   (d) This chapter shall not apply to a contract between a

contracting entity and a discount medical plan organization.



   (e) This chapter shall not apply to any entity, such as

employers, church plans or government plans, receiving administrative services

from the contracting entity or an affiliate entity. Such exempt entities shall

have the same rights and responsibilities under the provider network contracts

as the contracting entities, except the exempt entities shall not grant access

to a provider's health care services and contractual discounts to any other

entity.



History of Section.

(P.L. 2009, ch. 190, § 1; P.L. 2009, ch. 209, § 1.)