Idaho § 41-3928 INCENTIVES TO WITHHOLD CARE PROHIBITED

Idaho Statutes

§ 41-3928 — INCENTIVES TO WITHHOLD CARE PROHIBITED

Idaho § 41-3928

Title 41INSURANCE

Ch. 39MANAGED CARE REFORM

This text of Idaho § 41-3928 (INCENTIVES TO WITHHOLD CARE PROHIBITED) is published on Counsel Stack Legal Research, covering Idaho primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Idaho Code § 41-3928 (2026).

Text

(1)No managed care organization shall offer a provider and no contract between a managed care organization and a provider shall contain any incentive plan that includes a specific payment made, in any type or form, to the provider as an inducement to deny, reduce, limit, or delay specific, medically necessary, and appropriate services covered by the health care contract and provided with respect to a specific member or group of members with similar medical conditions.

(2)Nothing in this section shall be construed to prohibit contracts that contain incentive plans that involve general payments such as capitation payments or shared risk agreements that are not tied to specific medical decisions involving specific members or groups of members with similar medical conditions.

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(1) No managed care organization shall offer a provider and no contract between a managed care organization and a provider shall contain any incentive plan that includes a specific payment made, in any type or form, to the provider as an inducement to deny, reduce, limit, or delay specific, medically necessary, and appropriate services covered by the health care contract and provided with respect to a specific member or group of members with similar medical conditions.
(2) Nothing in this section shall be construed to prohibit contracts that contain incentive plans that involve general payments such as capitation payments or shared risk agreements that are not tied to specific medical decisions involving specific members or groups of members with similar medical conditions.