Notwithstanding any other law to the contrary, a health care insurer may:
I. Enter into contracts or other agreements with preferred providers for the delivery of health care services to covered persons. Such contracts or agreements may:
- (a) Establish the amount and method of payment to the preferred provider;
- (b) Establish a procedure for the review and control of utilization of health care services; and
- (c) Establish a mechanism for determining whether the health care services rendered are medically necessary.
- II. Issue or administer policies or contracts which provide incentives for the covered person to use the health care services of preferred providers.
- III. Issue or administer policies or contracts which provide benefits for health care services only if the services have been rendered by a preferred provider.
Source. 1987, 112:1, eff. July 5, 1987.