44-4717. Provider agreements.

238 words·~1 min read·/ne/chapter-44/44-4717

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

All contracts with providers or with entities subcontracting for the provision of limited health services to enrollees on a prepayment or other basis shall contain or shall 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, but not limited to, insolvency or breach of this contract, the enrollees shall not be liable to the provider for any sums owed to the provider under this contract;

(2)No provider or an 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 shall not prohibit collection of copayments from enrollees;

(4)These provisions shall survive the termination of this contract, regardless of the reason giving rise to the termination;

(5)Termination of this contract shall not release the provider from the obligations and duties imposed by this contract to complete procedures in progress on enrollees then receiving treatment for a specific condition for a period not to exceed thirty days at the same schedule of copayment or other applicable charge in effect upon the effective date of termination of this contract; and

(6)Any amendment to the provisions of this contract shall be submitted to and be approved by the director prior to becoming effective.