Sec. 38a-479cc. Duties of a preferred provider network when providing services pursuant to a contract with a managed care organization. - Connecticut Statutes

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Statutes > Connecticut > Title38a > Chap700c > Sec38a-479cc

      Sec. 38a-479cc. Duties of a preferred provider network when providing services pursuant to a contract with a managed care organization. (a) Whenever a preferred provider network is providing services pursuant to a contract with a managed care organization, the preferred provider network may not establish any terms, conditions or requirements for access, diagnosis or treatment that are different from the terms, conditions or requirements for access, diagnosis or treatment in the managed care organization's plan, except that no preferred provider network shall be required to provide an enrollee access to a provider who does not participate in the preferred provider network unless the preferred provider network is required to provide such access under its contract with the managed care organization.

      (b) Whenever a preferred provider network is providing services pursuant to a contract with a managed care organization, the preferred provider network shall pay for the delivery of health care services and operate and maintain arrangements or contracts with providers in a manner consistent with the provisions of law that apply to the managed care organization's contracts with enrollees and providers.

      (P.A. 03-169, S. 3; P.A. 06-196, S. 164.)

      History: P.A. 06-196 made a technical change in Subsec. (a), effective June 7, 2006.

State Codes and Statutes

Statutes > Connecticut > Title38a > Chap700c > Sec38a-479cc

      Sec. 38a-479cc. Duties of a preferred provider network when providing services pursuant to a contract with a managed care organization. (a) Whenever a preferred provider network is providing services pursuant to a contract with a managed care organization, the preferred provider network may not establish any terms, conditions or requirements for access, diagnosis or treatment that are different from the terms, conditions or requirements for access, diagnosis or treatment in the managed care organization's plan, except that no preferred provider network shall be required to provide an enrollee access to a provider who does not participate in the preferred provider network unless the preferred provider network is required to provide such access under its contract with the managed care organization.

      (b) Whenever a preferred provider network is providing services pursuant to a contract with a managed care organization, the preferred provider network shall pay for the delivery of health care services and operate and maintain arrangements or contracts with providers in a manner consistent with the provisions of law that apply to the managed care organization's contracts with enrollees and providers.

      (P.A. 03-169, S. 3; P.A. 06-196, S. 164.)

      History: P.A. 06-196 made a technical change in Subsec. (a), effective June 7, 2006.

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State Codes and Statutes

Statutes > Connecticut > Title38a > Chap700c > Sec38a-479cc

      Sec. 38a-479cc. Duties of a preferred provider network when providing services pursuant to a contract with a managed care organization. (a) Whenever a preferred provider network is providing services pursuant to a contract with a managed care organization, the preferred provider network may not establish any terms, conditions or requirements for access, diagnosis or treatment that are different from the terms, conditions or requirements for access, diagnosis or treatment in the managed care organization's plan, except that no preferred provider network shall be required to provide an enrollee access to a provider who does not participate in the preferred provider network unless the preferred provider network is required to provide such access under its contract with the managed care organization.

      (b) Whenever a preferred provider network is providing services pursuant to a contract with a managed care organization, the preferred provider network shall pay for the delivery of health care services and operate and maintain arrangements or contracts with providers in a manner consistent with the provisions of law that apply to the managed care organization's contracts with enrollees and providers.

      (P.A. 03-169, S. 3; P.A. 06-196, S. 164.)

      History: P.A. 06-196 made a technical change in Subsec. (a), effective June 7, 2006.