Rhode Island § 27-41-52 § 27-41-52. Restricted annual rate payments prohibited.

Rhode Island Statutes

§ 27-41-52 — § 27-41-52. Restricted annual rate payments prohibited.

Rhode Island·Title 27 Insurance·Ch. 27-41 Health Maintenance Organizations

§ 27-41-52. Restricted annual rate payments prohibited.
(a) No corporation organized under this chapter shall compensate any provider of outpatient
            service by using the restricted annual rate method of payment.
         
(b) The restricted annual rate method of payment is defined as any method of payment that
            sets, as all or part of its payment scheme, a total payment limit for mental health
            and/or substance abuse treatment services for each person seeking treatment based
            on a per-person, per-unit-of-time criterion that disregards the extent of treatment
            and/or degree of services rendered.
         
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§ 27-41-52. Restricted annual rate payments prohibited.

(a) No corporation organized under this chapter shall compensate any provider of outpatient service by using the restricted annual rate method of payment.

(b) The restricted annual rate method of payment is defined as any method of payment that sets, as all or part of its payment scheme, a total payment limit for mental health and/or substance abuse treatment services for each person seeking treatment based on a per-person, per-unit-of-time criterion that disregards the extent of treatment and/or degree of services rendered.

(c) This prohibition shall not be construed to prohibit or limit capitation or other risk-sharing agreements between providers and insurers permissible by law.

Rhode Island § 27-41-52 (§ 27-41-52. Restricted annual rate payments prohibited.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.