Coinsurance payment, calculation from negotiated alternative
rates, requirements added .............................................................

Coverage for individuals under guardianship, provisions added ...

Diabetes equipment, supplies, and self-management training and
educational services, coverage requirements added ....................

Emerging medical and surgical treatments, insurance carriers
required to provide and disclose process for evaluating, and to
establish patient selection criteria for such treatment for which
coverage is provided .......................................................................

Health care practitioner payment system, implementation
delayed, and study and report requirements added ....................

Insurance fraud prevention fee, applicability and times and
method of payment, provisions altered........................................

Medical screening services, reimbursement of hospital emergency
facilities and providers by health maintenance organizations,
provisions amended ........................................................................

Methodology to determine payment to nonparticipating health
care providers for services provided under a Medicare contract,
provisions altered ...........................................................................

Notice of renewal of group policies, requirements added ...............

Osteoporosis, coverage for procedure to identify bone mass or
detect bone loss, requirements added ...........................................

Physician reimbursement methodology and distribution of
premium dollars, disclosure in enrollment sales materials,
requirements added .......................................................................

"Point-of-service option", definition altered ...................................

Portability and Accountability Act, reforms to guarantee issue and
renewability, set maximum rates, and prohibit preexisting
condition limitations to persons moving from the group to
individual market and to limit preexisting condition limitations
in the large group market, provisions added ...............................

Prescribed maintenance drug, supply quantity allowed by an
insurer in a single dispensing, provisions altered .......................

Prostate cancer diagnostic tests, coverage requirements added ....

Referral of subscriber who is a continuing care facility resident to
the skilled nursing unit of the facility for follow-up care after
acute care services, provisions added ...........................................

Reimbursement of health care providers, minimum amount of
time to submit claim for reimbursement and maximum time for
reimbursement, provisions added .................................................

Retroactive denial of reimbursement to health care providers,
restrictions added ...........................................................................

Substantial, available, and affordable coverage in the nongroup
market, Health Care Access and Cost Commission required to
adopt regulations specifying a plan for ........................................

- 5121 -

INDEX

Chapter

Page

712	4090
256	2051
167	1803
168	1806
332	2380
134	1728
649	3648
107	1583
199	1908
300	2190
217	1952
145	1758
697	4027
294	2138
232	2001
356	2481
357	2483
161	1792
590	3255
163	1796
245	2025