Chapter 27-20 - NONPROFIT MEDICAL SERVICE CORPORATIONS

Section 27-20-1 - Definitions
Section 27-20-1.1 - Applicability
Section 27-20-2 - Organization as charitable corporation - Insurance laws inapplicable
Section 27-20-3 - Qualifications of directors
Section 27-20-4 - Approval of articles of association
Section 27-20-5 - Contracts with subscribers
Section 27-20-5.1 - Cancellation of coverage by employers
Section 27-20-5.2 - [Repealed]
Section 27-20-5.3 - Patient responsibility - Administrative requirements
Section 27-20-6 - Rates charged subscribers - reserves - hearing by commissioner
Section 27-20-6.1 - Uniform explanation of benefits and coverage
Section 27-20-6.2 - Filing of policy forms
Section 27-20-7 - Relationship of physician and patient - Actions against corporation
Section 27-20-8 - Annual and quarterly statements
Section 27-20-9 - Examination of affairs of corporation
Section 27-20-10 - Commission plans for solicitors or insurance producers
Section 27-20-11 - Investment standards
Section 27-20-12 - Corporation deemed public charitable institution
Section 27-20-13 - Adoption of chapter by hospital service corporation
Section 27-20-14 - Coverage for adoptive children
Section 27-20-15 - Itemized bills for services rendered
Section 27-20-16 - Changing coverage
Section 27-20-17 - Mammograms and pap smears - coverage mandated
Section 27-20-17.1 - Insurance coverage for post-partum hospital stays
Section 27-20-18 - Mammograms - Quality assurance standards
Section 27-20-19 - Pap smears - Quality assurance standards
Section 27-20-20 - Coverage for infertility
Section 27-20-21 - Nonprofit medical service corporation assessment
Section 27-20-22 - Discontinuance of coverage - Chronic disabilities
Section 27-20-23 - Drug coverage
Section 27-20-23.1 - Pharmacy benefit manager requirements with respect to multi-source generic pricing updates to pharmacies
Section 27-20-23.2 - Medication synchronization
Section 27-20-24 - Rehabilitation, liquidation, or conservation
Section 27-20-25 - Holding company systems
Section 27-20-25.1 - No derogation of attorney general
Section 27-20-25.2 - Health insurance rates
Section 27-20-26 - Regulations
Section 27-20-27 - New cancer therapies - Under investigation. [Repealed on effective date of Section 27-20-64.]
Section 27-20-27.1 - "Reliable evidence" defined. [Repealed on effective date of Section 27-20-64.]
Section 27-20-27.2 - Conditions of coverage. [Repealed on effective date of Section 27-20-64.]
Section 27-20-27.3 - Managed care. [Repealed on effective date of Section 27-20-64.]
Section 27-20-28 - [Repealed]
Section 27-20-29 - Mastectomy treatment
Section 27-20-29.1 - Insurance coverage for mastectomy hospital stays
Section 27-20-30 - Diabetes treatment
Section 27-20-31 - Primary and preventive obstetric and gynecological care
Section 27-20-31.1 - Hysterectomy or myomectomy treatment
Section 27-20-32 - Whistleblowers protection
Section 27-20-33 - Penalties and remedies
Section 27-20-34 - Additional relief and damages - Reinstatement
Section 27-20-35 - Third party reimbursement for services of certain health care workers
Section 27-20-35.1 - Third party reimbursement for services of registered nurse first assistants
Section 27-20-36 - Human leukocyte antigen testing
Section 27-20-37 - Drug coverage
Section 27-20-37.1 - [Effective 1/1/2025] Specialty drugs
Section 27-20-38 - Restricted annual rate payments prohibited
Section 27-20-39 - Genetic testing
Section 27-20-39.1 - Genetic information
Section 27-20-40 - [Repealed]
Section 27-20-41 - Magnetic resonance imaging - Quality assurance standards
Section 27-20-42 - Acupuncture services
Section 27-20-43 - FDA approved prescription contraceptive drugs and devices
Section 27-20-44 - Prostate and colorectal examinations - coverage mandated - the maryellen goodwin colorectal cancer screening act
Section 27-20-45 - Eligibility for children's benefits
Section 27-20-46 - Hearing aids
Section 27-20-47 - Prompt processing of claims
Section 27-20-48 - Mandatory coverage for certain lyme disease treatments
Section 27-20-49 - Dental insurance assignment of benefits
Section 27-20-50 - Coverage for early intervention services
Section 27-20-51 - Post-payment audits
Section 27-20-52 - Reimbursement for orthotics and prosthetic services
Section 27-20-53 - Tobacco cessation programs
Section 27-20-54 - Mandatory coverage for scalp hair prosthesis
Section 27-20-55 - Licensed ambulance service
Section 27-20-56 - Enteral nutrition products
Section 27-20-57 - Prohibition on preexisting condition exclusions
Section 27-20-58 - Prohibition on rescission of coverage
Section 27-20-59 - Annual and lifetime limits
Section 27-20-60 - Coverage for individuals participating in approved clinical trials
Section 27-20-61 - Medical loss ratio reporting and rebates
Section 27-20-62 - Emergency services
Section 27-20-63 - Internal and external appeal of adverse benefit determinations
Section 27-20-64 - Reserved
Section 27-20-65 - Primary care provider designation requirement
Section 27-20-66 - Discretionary clauses
Section 27-20-67 - Orally administered anticancer medication - Cost-sharing requirement
Section 27-20-68 - Consumer notification
Section 27-20-69 - Opioid antagonists
Section 27-20-70 - Unfair discrimination prohibited
Section 27-20-71 - Health care provider credentialing
Section 27-20-72 - Health insurance contracts - full year coverage for contraception
Section 27-20-73 - Gender rating
Section 27-20-74 - Prohibition on discrimination in organ transplants
Section 27-20-75 - Health insurance contracts - copayments exemption for covid-19 vaccinations
Section 27-20-76 - Perinatal doulas
Section 27-20-77 - Coverage for biomarker testing
Section 27-20-78 - Mandatory coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome
Section 27-20-79 - Epinephrine injectors
Section 27-20-80 - Coverage for treatment of pre-exposure prophylaxis (PREP) for the prevention of HIV and post-exposure prophylaxis (PEP) to prevent HIV infection
Section 27-20-81 - Expedited prior authorization
Section 27-20-82 - Dispensing and administration of HIV PREP or PEP drugs