(1)A person or entity shall
not assign, allow access to, sell, rent, or give the person's or entity's rights to the
health-care provider's services pursuant to the person's or entity's contract unless
the person or entity complies with the requirements of this section.
(2)A person or entity may assign, allow access to, sell, rent, or give his, her,
or its rights to the health-care provider's services pursuant to the person's or
entity's contract if one of the following situations exists:
(a)The third party accessing the health-care provider's services under the
contract is an employer or other entity providing coverage for health-care services
to its employees or members and such employer or entity has, with the person or
entity contracting with the health-care provider, a con
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(1) A person or entity shall
not assign, allow access to, sell, rent, or give the person's or entity's rights to the
health-care provider's services pursuant to the person's or entity's contract unless
the person or entity complies with the requirements of this section.
(2) A person or entity may assign, allow access to, sell, rent, or give his, her,
or its rights to the health-care provider's services pursuant to the person's or
entity's contract if one of the following situations exists:
(a) The third party accessing the health-care provider's services under the
contract is an employer or other entity providing coverage for health-care services
to its employees or members and such employer or entity has, with the person or
entity contracting with the health-care provider, a contract for the administration or
processing of claims for payment or service provided pursuant to the contract with
the health-care provider;
(b) The third party accessing the health-care provider's services under the
contract is an affiliate of, subsidiary of, or is under common ownership or control
with the person or entity; or, is providing or receiving administrative services from
the person or entity or an affiliate of, or subsidiary of, or is under common
ownership or control with the person or entity; or
(c) The health-care contract specifically provides that it applies to network
rental arrangements and states that it is for the purpose of assigning, allowing
access to, selling, renting, or giving the person's or entity's rights to the health-care
provider's services.
(3) In addition to satisfying the requirements of subsection (2) of this section,
a person or entity may assign, allow access to, sell, rent, or give his, her, or its rights
under the contract to the services of the health-care provider only if:
(a) The individuals receiving services under the health-care provider's
contract are provided with appropriate identification stating where claims should
be sent and where inquiries should be directed; and
(b) The third party accessing the health-care provider's services through the
health-care provider's contract is obligated to comply with all applicable terms and
conditions of the contract; except that a self-funded plan receiving administrative
services from the person or entity or its affiliates shall be solely responsible for
payment to the provider.