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62K.075 PROVIDER NETWORK NOTIFICATIONS.

(a) A health carrier must update the carrier's website at least once a month with any changes to the carrier's provider network, including provider changes from in-network status to out-of-network status.

(b) Upon notification from an enrollee, a health carrier must reprocess any claim for services provided by a provider whose status has changed from in-network to out-of-network as an in-network claim if the service was provided after the network change went into effect but before the change was posted as required under paragraph (a) unless the health carrier notified the enrollee of the network change prior to the service being provided. This paragraph does not apply if the health carrier is able to verify that the health carrier's website displayed the correct provider network status on the health carrier's website at the time the service was provided.

(c) The limitations of section 62Q.56, subdivision 2a, shall apply to payments required by paragraph (b).

History:

2016 c 179 s 1