Idaho Code
Chapter 39 - MANAGED CARE REFORM
Section 41-3925 - SERVICES PROVIDED BY GOVERNMENTAL ENTITIES.

41-3925. SERVICES PROVIDED BY GOVERNMENTAL ENTITIES. (1) From and after July 1, 1990, no contract shall be issued in Idaho by an organization offering a managed care plan for which a certificate of authority is required which excludes from coverage services rendered the member while a resident in an Idaho state institution, provided the services to the member would be covered by the contract if rendered to him outside an Idaho state institution.
(2) From and after July 1, 1990, no contract issued by an organization offering a managed care plan for which a certificate of authority is required may contain any provision denying or reducing benefits otherwise provided under the policy for the reason that the person insured is receiving health or mental health care or developmental services provided by the department of health and welfare, whether or not the department of health and welfare bases its charges for such services on the recipient’s ability to pay. Provided, nothing in this section shall prevent the issuance of a contract which excludes or reduces benefits where the charge level or amount of the charge levied by a governmental entity for such services would vary or be affected in any way by the existence of coverage under the managed care plan.

History:
[(41-3925), added 1990, ch. 300, sec. 4, p. 829; am. and redesig. 1997, ch. 204, sec. 28, p. 599.]

Structure Idaho Code

Idaho Code

Title 41 - INSURANCE

Chapter 39 - MANAGED CARE REFORM

Section 41-3901 - SHORT TITLE.

Section 41-3902 - INTENT AND PURPOSE.

Section 41-3903 - DEFINITIONS.

Section 41-3904 - CERTIFICATE OF AUTHORITY REQUIRED — EXCEPTIONS — APPLICATION OF CERTAIN PROVISIONS.

Section 41-3905 - QUALIFICATIONS FOR CERTIFICATE OF AUTHORITY.

Section 41-3906 - APPLICATION FOR CERTIFICATE OF AUTHORITY.

Section 41-3909 - RECORDS.

Section 41-3910 - REPORTS TO THE DIRECTOR.

Section 41-3911 - EXAMINATIONS.

Section 41-3912 - SUSPENSION OR REVOCATION OF CERTIFICATE OF AUTHORITY.

Section 41-3914 - ANNUAL DISCLOSURES.

Section 41-3915 - HEALTH CARE CONTRACTS.

Section 41-3916 - ADVISORY PANELS.

Section 41-3917 - CERTAIN WORDS PROHIBITED IN NAME OF ORGANIZATION.

Section 41-3918 - GRIEVANCE SYSTEM.

Section 41-3919 - OPEN ENROLLMENT.

Section 41-3920 - DISCRIMINATION AGAINST HEALTH PROFESSIONALS ASSOCIATED WITH MANAGED CARE ORGANIZATIONS.

Section 41-3921 - STATUTORY CONSTRUCTION AND RELATIONSHIP TO OTHER LAWS.

Section 41-3922 - TAXATION — PENALTY FOR FAILURE TO FILE.

Section 41-3923 - COVERAGE OF ADOPTED NEWBORN CHILDREN — COVERAGE OF MATERNITY AND COMPLICATIONS OF PREGNANCY.

Section 41-3924 - LIMITATION OF BENEFITS FOR ELECTIVE ABORTIONS.

Section 41-3925 - SERVICES PROVIDED BY GOVERNMENTAL ENTITIES.

Section 41-3926 - MAMMOGRAPHY COVERAGE.

Section 41-3927 - HEALTH CARE PROVIDERS — PARTICIPATION BY ANY QUALIFIED, WILLING PROVIDER — CONTRACTS — GRIEVANCE PROCEDURE.

Section 41-3928 - INCENTIVES TO WITHHOLD CARE PROHIBITED.

Section 41-3930 - UTILIZATION MANAGEMENT PROGRAM REQUIREMENTS.

Section 41-3931 - PARTICIPATION IN IDAHO LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION.

Section 41-3932 - EXEMPTIONS FROM APPLICATION OF CHAPTER.

Section 41-3940 - PREEXISTING CONDITIONS.