§ 26-22-503 — Policies with incentives or limits on reimbursement authorized; conditions

Wyoming § 26-22-503

• Jurisdiction: Wyoming
• Title 26: Insurance Code
• Ch. 22: HOSPITAL OR MEDICAL SERVICE INSURANCE AND

Text

(a) Notwithstanding any other provision of law to the
contrary:
(i) Any provider may enter into a written agreement
with any group or insurer relating to health care services which
may be rendered to insureds, including amounts to be charged the
insured for services rendered;
(ii) Any group or insured may contract with insurers
to issue policies which:
(A) Include incentives for the insured;
(B) Limit reimbursement for health care
services.
(iii) Before entering into any written agreement
under paragraph (a)(i) of this section, the group or insurer
shall establish terms and conditions to be required of any
provider interested in entering into the agreement. In no event
shall the established terms and conditions discriminate against
any Wyoming provider nor shall any Wyoming provider willing to
meet the established terms and conditions be denied the right to
enter into any written agreement;
(iv) This section shall not be construed to expand
the scope of coverage as defined by any agreement.
(b) In no event may an insurer deny or limit reimbursement
to an insured under this article on the grounds that the insured
was not referred to the provider by a person acting on behalf of
or under an agreement with the insurer.
(c) Any group may contract with an insurer, preferred
provider organization or health maintenance organization for
provision of medical services outside of Wyoming for the
insureds of that group, provided the insureds are not restricted
from utilizing any Wyoming provider who provides the same health
care services.