§ 26.1-17.1-16 — Contracts with providers

North Dakota § 26.1-17.1-16

• Jurisdiction: North Dakota
• Title 26.1: Insurance
• Ch. 26.1-17.1: Prepaid Limited Health Service Organizations

Text

All contracts with providers or with entities subcontracting for the provision of limited health
services to enrollees on a prepayment or other basis must contain or must be construed to
contain the following terms and conditions:
1. In the event the prepaid limited health service organization fails to pay for limited
health services for any reason whatsoever, including insolvency or breach of this
contract, the enrollees are not liable to the provider for any sums owed to the provider
under this contract.
2. No provider, agent, trustee, or assignee thereof may maintain an action at law or
attempt to collect from the enrollee sums owed to the provider by the prepaid limited
health service organization.
3. These provisions do not prohibit collection of uncovered charges consented to by
enrollees or collection of copayments from enrollees.
4. These provisions survive the termination of this contract, regardless of the reason
giving rise to termination.
5. Termination of this contract does not release the provider from completing procedures
in progress on enrollees then receiving treatment for a specific condition for a period
not to exceed sixty days, at the same schedule of copayment or other applicable
charge in effect upon the effective date of termination of this contract.
6. Any amendment to these foregoing provisions of this contract must be submitted to
and be approved by the commissioner prior to becoming effective.