Title 31 — Insurance and Securities.
94 chapters · 1,236 sections in this title.
D.C. Code § 31-3201 Standardized uniform health insurance claims forms
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(a) The HCFA 1500 and UB 92 claims forms, or their successor forms as they may be amended from time to time, shall serve as the official health insurance claims forms of the District of Columbia for hospitals and other medical providers and governmental agencies, and such forms s…
D.C. Code § 31-3231 Definitions
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For the purposes of this subchapter, the term: (1) “Health benefit plan” means any accident and health insurance policy or certificate, hospital and medical services corporation contract, health maintenance organization subscriber contract, plan provided by a multiple employer we…
D.C. Code § 31-3232 Uniform consultation referral forms
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(a) This subchapter shall apply to all health insurers that issue or deliver individual or group health benefit plans in the District of Columbia. (b) All health insurers that require the insured to have a written referral to receive consultation services shall use the uniform co…
D.C. Code § 31-3233 Regulations
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(a) The Commissioner shall promulgate regulations to implement the provisions of this subchapter. The regulations shall include a uniform consultation referral form for use by health insurers that require enrollees or subscribers to have a written referral to receive consultation…
D.C. Code § 31-3234 Applicability
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This subchapter shall apply to health insurers beginning with referrals issued 120 days after the promulgation of final regulations under § 31-3233.
D.C. Code § 31-3251 Definitions
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For the purposes of this subchapter, the term: (1) “Commissioner” means Commissioner of the Department of Insurance and Securities Regulation. (2) “Credentialing intermediary” means a person to whom a health insurer has delegated credentialing or recredentialing authority and res…
D.C. Code § 31-3252 Application for becoming credentialed
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(a) A health insurer or its credentialing intermediary shall accept the uniform credentialing form as the sole application for a health care provider to become credentialed or recredentialed for a provider panel of the health insurer. (b) A health insurer or its credentialing int…
D.C. Code § 31-3253 Penalties
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The Commissioner may impose a penalty not to exceed $500 against any health insurer for each violation of this subchapter by the health insurer or its credentialing intermediary.
D.C. Code § 31-3254 Regulations
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The Commissioner shall promulgate rules and regulations to implement the provisions of this subchapter.
D.C. Code § 31-3255 Applicability
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This subchapter shall apply, 120 days after the promulgation of the final regulations pursuant to § 31-3254, to health insurers, as defined in § 31-3251(5), and any agency, organization, facility, or distinct part thereof, licensed pursuant to subchapter I of Chapter 5 of Title 4…