42 U.S.C. § 300gg-5

Current through P.L. 116-138 (04/10/2020)
Section 300gg-5 - Non-discrimination in health care
(a) Providers

A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures.

(b) Individuals

The provisions of section 218c 1 of title 29 (relating to non-discrimination) shall apply with respect to a group health plan or health insurance issuer offering group or individual health insurance coverage.

1 See References in Text note below.

42 U.S.C. § 300gg-5

July 1, 1944, ch. 373, title XXVII, §2706, as added Pub. L. 111-148, title I, §1201(4), Mar. 23, 2010, 124 Stat. 160.

REFERENCES IN TEXT Section 218c of title 29, referred to in subsec. (b), was in the original "section 1558 of the Patient Protection and Affordable Care Act", meaning section 1558 of Pub. L. 111-148 and was translated as meaning section 18C of act June 25, 1938, ch. 676, which was added by section 1558 of Pub. L. 111-148 to reflect the probable intent of Congress.

PRIOR PROVISIONSA prior section 300gg-5, act July 1, 1944, ch. 373, title XXVII, §2705, as added Pub. L. 104-204, title VII, §703(a), Sept. 26, 1996, 110 Stat. 2947, and amended, which related to parity in mental health and substance use disorder benefits, was renumbered section 2726 of act July 1, 1944, and transferred to section 300gg-26 of this title.A prior section 2706 of act July 1, 1944, was renumbered section 2727 and is classified to section 300gg-27 of this title.Another prior section 2706 of act July 1, 1944, was successively renumbered by subsequent acts and transferred, see section 238e of this title.

EFFECTIVE DATESection effective for plan years beginning on or after Jan. 1, 2014, see section 1255 of Pub. L. 111-148 set out as a note under section 300gg of this title.