PREFERRED PROVIDER AGREEMENTS
420-C:3 Reimbursement Agreements.
Notwithstanding any other law to the contrary, a health care insurer may:
I. Enter into contracts or other agreements with preferred providers for the delivery of health care services to covered persons. Such contracts or agreements may:
(a) Establish the amount and method of payment to the preferred provider;
(b) Establish a procedure for the review and control of utilization of health care services; and
(c) Establish a mechanism for determining whether the health care services rendered are medically necessary.
II. Issue or administer policies or contracts which provide incentives for the covered person to use the health care services of preferred providers.
III. Issue or administer policies or contracts which provide benefits for health care services only if the services have been rendered by a preferred provider.
Source. 1987, 112:1, eff. July 5, 1987.