§ 26.1-53.1-16 — Provider agreements

North Dakota § 26.1-53.1-16

• Jurisdiction: North Dakota
• Title 26.1: Insurance
• Ch. 26.1-53.1: Discount Plans

Text

1. A discount plan organization must have a written provider agreement with all providers
offering medical or ancillary services to the organization's members. The written
provider agreement may be entered directly with the provider or indirectly with a
provider network to which the provider belongs.

2. A provider agreement between a discount plan organization and a provider must
provide the following:
a. A list of the medical or ancillary services and products to be provided at a
discount;
b. The amount or amounts of the discounts or, alternatively, a fee schedule that
reflects the provider's discounted rates; and
c. That the provider will not charge members more than the discounted rates.
3. A provider agreement between a discount plan organization and a provider network
must require that the provider network have written agreements with the provider
network's providers which:
a. Contain the provisions described in subsection 2;
b. Authorize the provider network to contract with the discount plan organization on
behalf of the provider; and
c. Require the provider network to maintain an up-to-date list of the provider
network's contracted providers and to provide the list on a monthly basis to the
discount plan organization.
4. A provider agreement between a discount plan organization and an entity that
contracts with a provider network must require that the entity, in the entity's contract
with the provider network, require the provider network to have written agreements
with the provider network's providers which comply with subsection 3.
5. The discount plan organization shall maintain a copy of each active provider
agreement into which the organization has entered.