Current with legislation from 2024 Fiscal and Special Sessions.
Section 23-99-1203 - All-products clause - Prohibition(a) Except as provided in subsections (b) and (d) of this section, a contracting entity shall not:(1) Offer to a healthcare provider a healthcare contract that includes an all-products clause;(2) Enter into a healthcare contract with a healthcare provider that includes an all-products clause; or(3) Amend or renew an existing healthcare contract previously entered into with a healthcare provider so that the healthcare contract as amended or renewed adds or continues to include an all-products clause.(b)(1) This section does not prohibit a contracting entity from:(A) Offering a healthcare provider a contract that covers multiple health benefit plans that have the same reimbursement rates and other financial terms for the healthcare provider;(B) Adding a new health benefit plan to an existing healthcare contract with a healthcare provider under the same reimbursement rates and other financial terms applicable under the original healthcare contract; or(C) Requiring a healthcare provider to accept multiple health benefit plans that do not differ in reimbursement rates or other financial terms for the healthcare provider.(2) A healthcare contract may include health benefit plans or coverage options for enrollees within a health benefit plan with different cost-sharing structures, including different deductibles or copayments, as long as the reimbursement rates and other financial terms between the contracting entity and the healthcare provider remain the same for each plan or coverage option included in the healthcare contract.(3) This section does not authorize a healthcare provider to:(A) Opt out of providing services to an enrollee of a particular health benefit plan after the healthcare provider has entered into a valid contract under this section to provide the services; or(B) Refuse to disclose the provider networks or health benefit plans in which the healthcare provider participates.(c)(1) A violation of this section is:(A) An unfair trade practice under § 23-66-206; and(B) Subject to the Trade Practices Act, § 23-66-201 et seq.(2) If a healthcare contract contains a provision that violates this section, the healthcare contract is void.(d) A contracting entity may require a healthcare provider to participate in the State and Public School Life and Health Insurance Program as a condition of contracting or continuing to contract with the healthcare provider for healthcare services under another health benefit plan, if: (1) The other health benefit plan is an individual health plan not sold on the health insurance marketplace, as defined in § 23-64-602; and(2) The rates offered to the healthcare provider for healthcare services to program enrollees are no lower than the rates paid to the healthcare provider under the other health benefit plan.Added by Act 2019, No. 734,§ 1, eff. 7/24/2019.