31 Pa. Code § 301.122

Current through Register Vol. 55, No. 1, January 4, 2025
Section 301.122 - Hold harmless

A contract between an HMO and a participating provider of health care services shall include a provision to the following effect:

(Provider) hereby agrees that in no event, including, but not limited to non-payment by the HMO, HMO insolvency or breach of this agreement, shall (Provider) bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against subscriber/enrollee or persons other than HMO acting on their behalf for services listed in this Agreement. This provision shall not prohibit collection of supplemental charges or copayments on the HMO's or provider's behalf made in accordance with the terms of the applicable agreement between the HMO and subscriber/enrollee. "(Provider) further agrees that (1) the hold harmless provisions herein shall survive the termination of the (applicable Provider contract) regardless of the cause giving rise to termination and shall be construed to be for the benefit of the HMO subscriber/enrollee and that (2) this hold harmless provision supersedes any oral or written contrary agreement now existing or hereafter entered into between (Provider) and subscriber/enrollee or persons acting on their behalf. "Any modification, addition, or deletion to the provisions of this section shall become effective on a date no earlier than fifteen (15) days after the Secretary of Health has received written notice of such proposed changes."

31 Pa. Code § 301.122

This section is cited in 31 Pa. Code § 301.314 (relating to Department review).