§58‑51‑40. Insurers and others to afford coverage for activemedical treatment in tax‑supported institutions.
(a) Whenever any policyof insurance governed by Articles 1 through 64 of this Chapter provides forbenefits for charges of hospitals or physicians, the policy shall provide forpayments of benefits for charges made for medical care rendered in or by dulylicensed State tax‑supported institutions, including charges for medicalcare of cerebral palsy, other orthopedic and crippling disabilities, mental andnervous diseases or disorders, mental retardation, alcoholism and drug orchemical dependency, and respiratory illness, on a basis no less favorable thanthe basis which would apply had the medical care been rendered in or by anyother public or private institution or provider. The term "State tax‑supportedinstitutions" shall include community mental health centers and otherhealth clinics which are certified as Medicaid providers.
(b) No policy shallexclude payment for charges of a duly licensed State tax‑supportedinstitution because of its being a specialty facility for one particular typeof illness nor because it does not have an operating room and related equipmentfor the performance of surgery, but it is not required that benefits be payablefor domiciliary or custodial care, rehabilitation, training, schooling, oroccupational therapy.
(c) The restrictionsand regulations of this section shall not apply to any policy which isindividually underwritten or provided for a specific individual and the membersof his family as a nongroup policy but shall apply to any group policy ofinsurance governed by Articles 1 through 64 of this Chapter. (1975,c. 345, s. 1; 1981, c. 816, ss. 1, 2.)
§58‑51‑40. Insurers and others to afford coverage for activemedical treatment in tax‑supported institutions.
(a) Whenever any policyof insurance governed by Articles 1 through 64 of this Chapter provides forbenefits for charges of hospitals or physicians, the policy shall provide forpayments of benefits for charges made for medical care rendered in or by dulylicensed State tax‑supported institutions, including charges for medicalcare of cerebral palsy, other orthopedic and crippling disabilities, mental andnervous diseases or disorders, mental retardation, alcoholism and drug orchemical dependency, and respiratory illness, on a basis no less favorable thanthe basis which would apply had the medical care been rendered in or by anyother public or private institution or provider. The term "State tax‑supportedinstitutions" shall include community mental health centers and otherhealth clinics which are certified as Medicaid providers.
(b) No policy shallexclude payment for charges of a duly licensed State tax‑supportedinstitution because of its being a specialty facility for one particular typeof illness nor because it does not have an operating room and related equipmentfor the performance of surgery, but it is not required that benefits be payablefor domiciliary or custodial care, rehabilitation, training, schooling, oroccupational therapy.
(c) The restrictionsand regulations of this section shall not apply to any policy which isindividually underwritten or provided for a specific individual and the membersof his family as a nongroup policy but shall apply to any group policy ofinsurance governed by Articles 1 through 64 of this Chapter. (1975,c. 345, s. 1; 1981, c. 816, ss. 1, 2.)
§58‑51‑40. Insurers and others to afford coverage for activemedical treatment in tax‑supported institutions.
(a) Whenever any policyof insurance governed by Articles 1 through 64 of this Chapter provides forbenefits for charges of hospitals or physicians, the policy shall provide forpayments of benefits for charges made for medical care rendered in or by dulylicensed State tax‑supported institutions, including charges for medicalcare of cerebral palsy, other orthopedic and crippling disabilities, mental andnervous diseases or disorders, mental retardation, alcoholism and drug orchemical dependency, and respiratory illness, on a basis no less favorable thanthe basis which would apply had the medical care been rendered in or by anyother public or private institution or provider. The term "State tax‑supportedinstitutions" shall include community mental health centers and otherhealth clinics which are certified as Medicaid providers.
(b) No policy shallexclude payment for charges of a duly licensed State tax‑supportedinstitution because of its being a specialty facility for one particular typeof illness nor because it does not have an operating room and related equipmentfor the performance of surgery, but it is not required that benefits be payablefor domiciliary or custodial care, rehabilitation, training, schooling, oroccupational therapy.
(c) The restrictionsand regulations of this section shall not apply to any policy which isindividually underwritten or provided for a specific individual and the membersof his family as a nongroup policy but shall apply to any group policy ofinsurance governed by Articles 1 through 64 of this Chapter. (1975,c. 345, s. 1; 1981, c. 816, ss. 1, 2.)
