I.
- (a) A discount medical plan organization shall have a written provider agreement with all participating providers. The written provider agreement shall be entered into directly with the provider or indirectly with a provider network to which the provider belongs.
(b) An agreement between a discount medical plan organization and a participating provider shall include the following:
- (1) A list of the medical or ancillary services and products to be provided at a discount;
- (2) The amount or amounts of the discounts or, alternatively, a fee schedule that reflects the provider's discounted rates; and
- (3) A statement that the provider will not charge members more than the discounted rates.
(c) An agreement between a discount medical plan organization and a provider network shall require that the provider network have written agreements with its providers that:
- (1) Contain the provisions described in subparagraph (b);
- (2) Authorize the provider network to contract with the discount medical plan organization on behalf of the provider; and
- (3) Require the provider network to maintain an up-to-date list of its contracted providers and to provide the list on a monthly basis to the discount medical plan organization.
- (d) An agreement between a discount medical plan organization and an entity that contracts with a provider network shall require that the entity, in its contract with the provider network, require the provider network to have written agreements with its providers that comply with subparagraph (c).
- (e) The discount medical plan organization shall maintain a copy of each active provider agreement into which it has entered.
- II. Each discount medical plan organization shall maintain on an Internet website page an up-to-date list of the names and addresses of the providers with which it has contracted directly or through a provider network. The Internet website address shall be prominently displayed on all of its advertisements, marketing materials, brochures, and discount medical plan cards.
Source. 2008, 206:1, eff. Jan. 1, 2009.