Chapter 420-J - MANAGED CARE LAW
- Section 420-J:1 - Purpose and Intent
- Section 420-J:2 - Applicability and Scope
- Section 420-J:3 - [Effective Until 1/1/2025] Definitions
- Section 420-J:3 - [Effective 1/1/2025] Definitions
- Section 420-J:3-a - Access to Enhanced 911 System
- Section 420-J:3-b - Pre-certification Requirement
- Section 420-J:4 - Credentialing Verification Procedures
- Section 420-J:4-a - Facility Credentialing
- Section 420-J:5 - [Effective Until 1/1/2025] Grievance Procedures
- Section 420-J:5 - [Effective 1/1/2025] Grievance Procedures
- Section 420-J:5-a - Right to External Review
- Section 420-J:5-b - Standard External Review
- Section 420-J:5-c - Expedited External Review
- Section 420-J:5-d - Certification of Independent Review Organizations
- Section 420-J:5-e - General Provisions Regarding External Review
- Section 420-J:6 - [Effective Until 1/1/2025] Utilization Review
- Section 420-J:6 - [Effective 1/1/2025] Utilization Review
- Section 420-J:6-a - Obstetrical-Gynecological Coverage
- Section 420-J:6-b - Self-Referrals for Chiropractic Care
- Section 420-J:6-c - Third-Party Payment of Covered, Court-Ordered Services
- Section 420-J:6-d - Coverage for Dependents
- Section 420-J:6-e - Coverage for Medically Necessary Dental Services
- Section 420-J:7 - Network Adequacy
- Section 420-J:7-a - [Repealed]
- Section 420-J:7-b - Prescription Drugs
- Section 420-J:7-c - Disqualification of Certain Physicians Prohibited
- Section 420-J:7-d - Continued Access to Care Subsequent to a Provider Contract Termination
- Section 420-J:7-e - Notice of Consumer Rights
- Section 420-J:8 - [Effective until 1/1/2025] Provider Contract Standards
- Section 420-J:8 - [Effective 1/1/2025] Provider Contract Standards
- Section 420-J:8-a - Prompt Payment Required
- Section 420-J:8-b - Retroactive Denials Prohibited; Exceptions
- Section 420-J:8-c - Reimbursement for Providers Waiting for Health Carrier Credentialing Verification
- Section 420-J:8-d - Dependent Coverage
- Section 420-J:8-e - [Effective Until 1/1/2025] Reasonable Value of Health Care Services
- Section 420-J:8-e - [Effective 1/1/2025] Determining The Fair Value Of Certain Health Care Items Or Services Provided By Nonparticipating Providers
- Section 420-J:8-f - Non-Covered Dental Services
- Section 420-J:8-g - [Effective 1/1/2025] Coverage And Payment For Emergency Services Provided By Nonparticipating Providers Or Nonparticipating Emergency Facilities
- Section 420-J:8-h - [Effective 1/1/2025] Coverage And Payment For Services Provided At Participating Facilities By Nonparticipating Providers
- Section 420-J:9 - Quality Assessment, Quality Improvement, and Reporting
- Section 420-J:10 - Confidentiality of Insurer Records
- Section 420-J:11 - Confidentiality of Insurance Department Records
- Section 420-J:12 - Rulemaking Authority
- Section 420-J:13 - Severability
- Section 420-J:14 - Penalties
- SUBSTANCE USE DISORDERS (§§ 420-J:15 — 420-J:19)