Carrier that offers network plan: Contracts with certain federally qualified health centers.
1. A carrier that offers a network plan shall use its best efforts to contract with at least one health center in each established geographic service area to provide health care as a member of the carrier’s defined set of providers under the network plan if the health center:
(a) Meets all conditions imposed by the carrier on similarly situated providers of health care that are members of the carrier’s defined set of providers, including, without limitation:
(1) Certification for participation in the Medicaid or Medicare program; and
(2) Requirements relating to the appropriate credentials for providers of health care; and
(b) Agrees to reasonable reimbursement rates that are generally consistent with those offered by the carrier to similarly situated providers of health care that are members of the carrier’s defined set of providers.
2. As used in this section, “health center” has the meaning ascribed to it in 42 U.S.C. § 254b.
Last modified: February 27, 2006