§ 27-74-9. Provider agreements — Provider listing requirements.
(a) A discount medical plan organization shall have a written provider agreement with
all providers offering medical or ancillary services to its members. The written provider
agreement may be entered into directly with the provider or indirectly with a provider
network to which the provider belongs.
(b) A provider agreement between a discount medical plan organization and a provider shall
provide the following:
(1) A list of the medical or ancillary services and products to be provided at a discount;
(2) The amount or amounts of the discounts or, alternatively, a fee schedule that reflects
the provider's discounted rates; and
(3) That the provider will not charge members more than the discounted rates.
(c) A provider agreement between a discount medical plan organization and a provider network
shall require that the provider network have written agreements with its providers
that:
(1) Contain the provisions described in subsection (b) of this section;
(2) Authorize the provider network to contract with the discount medical plan organization
on behalf of the provider; and
(3) Require the provider network to maintain an up-to-date list of its contracted providers
and to provide the list on a monthly basis to the discount medical plan organization.
(d) A provider agreement between a discount medical plan organization and an entity that
contracts with a provider network shall require that the entity, in its contract with
the provider network, require the provider network to have written agreements with
its providers that comply with subsection (c) of this section.
(e) The discount medical plan organization shall maintain a copy of each active provider
agreement into which it has entered.
(f) Each discount medical plan organization shall maintain on an internet website page
an up-to-date list of the names and addresses of the providers with which it has contracted
directly or through a provider network. The internet website address shall be prominently
displayed on all of its advertisements, marketing materials, brochures, and discount
medical plan cards.
(g) This subsection applies to those providers with which the discount medical plan organization
has contracted with directly as well as those providers that are members of a provider
network with which the discount medical plan organization has contracted.