Chapter 284-170. Health benefit plan management.  


Section 284-170-110. Purpose.
Section 284-170-120. Applicability and scope.
Section 284-170-125. Compliance with state and federal laws.
Section 284-170-130. Definitions.
Section 284-170-200. Network access—General standards.
Section 284-170-210. Alternate access delivery request.
Section 284-170-230. Maintenance of sufficient provider networks.
Section 284-170-240. Use of subcontracted networks.
Section 284-170-260. Provider directories.
Section 284-170-270. Every category of health care providers.
Section 284-170-280. Network reports—Format.
Section 284-170-300. Essential community providers for exchange plans—Definition.
Section 284-170-310. Essential community providers for exchange plans—Network access.
Section 284-170-320. Issuer recordkeeping—Provider networks.
Section 284-170-330. Tiered provider networks.
Section 284-170-340. Assessment of access.
Section 284-170-350. Issuer standards for women's right to directly access certain health care practitioners for women's health care services.
Section 284-170-360. Enrollee's access to providers.
Section 284-170-370. Hospital emergency service departments and practice groups.
Section 284-170-380. Standards for temporary substitution of contracted network providers—"Locum tenens" providers.
Section 284-170-390. Rule concerning contracted network providers called to active duty military service.
Section 284-170-401. Provider and facility contracts with issuers—Generally.
Section 284-170-411. Selection of participating providers—Credentialing and unfair discrimination.
Section 284-170-421. Provider contracts—Standards—Hold harmless provisions.
Section 284-170-431. Provider contracts—Terms and conditions of payment.
Section 284-170-440. Provider contracts—Dispute resolution process.
Section 284-170-450. Pharmacy identification cards.
Section 284-170-460. Provider contracts—Audit guidelines.
Section 284-170-470. Pharmacy claims—Rejections, notifications and disclosures.
Section 284-170-480. Participating provider—Filing and approval.
Section 284-170-490. Effective date.