Title 26.1 — Insurance

As used in this chapter, unless the context indicates otherwise: 1. "Air ambulance" means a specially equipped aircraft licensed by the department of health and human services for transporting patients. 2. "Air ambulance provider" means a publicly or privately owned organization …

Notwithstanding any provision of law to the contrary, any health care insurer may enter into preferred provider arrangements. 1. Preferred provider arrangements must: a. Establish the amount and manner of payment to the preferred provider. The amount and manner of payment may inc…

1. As used in this section, "covered services" means dental care services for which a reimbursement is available under an enrollee's plan or for which a reimbursement would be available but for the application of a deductible, copayment, coinsurance, waiting period, annual or lif…

1. As used in this section: a. "Affiliate" means a person that directly or indirectly through one or more intermediaries controls, or is under the control of, or is under common control with, the person specified. b. "Contracting entity" means a person that enters a direct contra…

1. As used in this section, "dental care provider" means a licensed provider of dental care services in this state. 2. Other than recovery for duplicate payments, a dental insurer, if engaging in overpayment recovery efforts, shall provide written notice to the dental care provid…

1. A preferred provider arrangement may not include restrictions on methods of payment from the dental insurer or third-party payor vendor to the dental provider in which the only acceptable payment method is a credit card payment. 2. If initiating or changing payments to a denta…

1. Health care insurers may issue policies or subscriber agreements which provide for incentives for covered persons to use the health care services of preferred providers. These policies or subscriber agreements must contain all of the following provisions: a. A provision that i…

Health care insurers may place reasonable limits on the number of classes of preferred providers which satisfy the standards set forth by the health care insurer, provided that there be no discrimination against any providers on the basis of religion, race, color, national origin…

1. As used in this section, the terms "continuing medical education", "maintenance of certification", "physician", and "specialty medical board certification" have the same meaning as provided under section 23-16-18. 2. A health care insurer may not deny reimbursement to or preve…

Health care insurers complying with this chapter are subject to all other applicable laws, rules, and regulations of this state.

The commissioner may adopt rules necessary to enforce and administer this chapter.

The commissioner may levy an administrative penalty not to exceed ten thousand dollars for a violation of this chapter.

An air ambulance provider, or an agent of an air ambulance provider, may not sell, solicit, or negotiate a subscription agreement or contract relating to services or the billing of services provided by an air ambulance provider. An air ambulance provider, or agent of an air ambul…

1. A health benefit plan may not be issued in this state unless the plan provides the reimbursement rate for out-of-network air ambulance provider services is equal to the average of the insurer's in-network rates for air ambulance providers in the state. 2. An insurer may not us…

If an action of Congress, the president of the United States, or a federal agency allows the state to regulate the rates, routes, or services of air ambulance providers, the commissioner may adopt rules consistent with the action taken. 26.1-47-12. Ambulance insurance coverage - …