Provides that a non-network pharmacy that provides causally related medications to a claimant shall be entitled to payment at the network rate negotiated between the carrier and the pharmacy network if the carrier's network provides mail order service or is located within a reasonable distance from the claimant; reduces costs of treatment by requiring out of network providers accept payment at the carrier's negotiated network rate, while at the same time allowing injured workers to obtain treatment in a timely manner by providing for payment to the provider when they do not obtain the treatment within the network; provides that any special diagnostic tests, x-ray examinations, magnetic resonance imaging or other radiological examinations or tests costing more than one thousand dollars performed by a provider who is not a member of the carrier's, self insured's or state insurance fund's diagnostic networks, shall be entitled to payment at the negotiated network rate.
Provides that a non-network pharmacy that provides causally related medications to a claimant shall be entitled to payment at the network rate negotiated between the carrier and the pharmacy network if the carrier's network provides mail order service or is located within a reasonable distance from the claimant; reduces costs of treatment by requiring out of network providers accept payment at the carrier's negotiated network rate, while at the same time allowing injured workers to obtain treatment in a timely manner by providing for payment to the provider when they do not obtain the treatment within the network; provides that any special diagnostic tests, x-ray examinations, magnetic resonance imaging or other radiological examinations or tests costing more than one thousand dollars performed by a provider who is not a member of the carrier's, self insured's or state insurance fund's diagnostic networks, shall be entitled to payment at the negotiated network rate.
Allows for treatment costing less than $1,500 to be done without prior approval, and more clearly defines the list of "pre-authorized procedures" as a floor on treatment as opposed to its current status as a ceiling; allows non-network providers of testing to be compensated at the provider network rate negotiated by the carrier.
Allows for treatment costing less than $1,500 to be done without prior approval, and more clearly defines the list of "pre-authorized procedures" as a floor on treatment as opposed to its current status as a ceiling; allows non-network providers of testing to be compensated at the provider network rate negotiated by the carrier.
Relates to reimbursement for ambulance services; requires insurers to submit payments directly to ambulance providers who are in-network or, for out-of-network ambulance providers, requires the issuance of a joint check to the insured specifying both the insured and the ambulance provider as payees.
Relates to reimbursement for ambulance services; requires insurers to submit payments directly to ambulance providers who are in-network or, for out-of-network ambulance providers, requires the issuance of a joint check to the insured specifying both the insured and the ambulance provider as payees.
Prohibits sex offenders from operating automobiles participating in mobile application based transportation networks or being employed by such transportation networks.
Requires Medicare and Medicaid managed care providers to provide coverage for certain out-of-network health care when the patient has a long term relationship with a medical professional who is not a recurring provider under the managed care provider's network.