40 Pa. Stat. § 1554

Current through P.A. Acts 2023-32
Section 1554 - Services which shall be provided
(a) Any law to the contrary notwithstanding, any corporation or limited liability company may establish, maintain and operate a health maintenance organization upon receipt of a certificate of authority to do so in accordance with this act.
(b) Such health maintenance organizations shall:
(1) Provide either directly or through arrangements with others, basic health services to individuals enrolled;
(2) Provide either directly or through arrangements with other persons, corporations, institutions, associations or entities, basic health services; and
(3) Provide physicians' services (i) directly through physicians who are employes of such organization, (ii) under arrangements with one or more groups of physicians (organized on a group practice or individual practice basis) under which each such group is reimbursed for its services primarily on the basis of an aggregate fixed sum or on a per capita basis, regardless of whether the individual physician members of any such group are paid on a fee-for-service or other basis or (iii) under similar arrangements which are found by the secretary to provide adequate financial incentives for the provision of quality and cost-effective care.

40 P.S. § 1554

Amended by P.L. 870 2014 No. 96, § 3, eff. 8/31/2014.
1972, Dec. 29, P.L. 1701, No. 364, § 4, imd. effective. Amended 1980, Dec. 19, P.L. 1300, No. 234, § 1, effective in 60 days.