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  6. Subtitle 304.17C - Limited Health Service Benef...


Subtitle 304.17C - Limited Health Service Benefit Plans


  • 304.17C-010 Definitions for subtitle.
  • 304.17C-020 Discrimination prohibited against willing provider located in area.
  • 304.17C-030 Disclosure.
  • 304.17C-040 Availability of provider network.
  • 304.17C-050 Standards for providers -- Mechanism for acting upon applications -- Policy governing removal of providers from network.
  • 304.17C-060 Filing of agreements -- Provisions of agreements -- Procedures for changing agreement -- Filing of risk-sharing arrangements and subcontracts -- Availability of information.
  • 304.17C-070 Prohibition of contract to limit disclosure to enrollee -- Actions for which provider may not be penalized -- Disclosure of arrangements between plan and providers.
  • 304.17C-080 Plan for selection and reevaluation of providers.
  • 304.17C-085 Set fees for noncovered services in participating provider agreement prohibited.
  • 304.17C-090 Payment of claims of dental-only benefits -- Reports -- Interest.
  • 304.17C-100 Payment for coverage of services within scope of practice of optometrists.
  • 304.17C-110 Limitation on amount of copayment or coinsurance charged for services rendered by chiropractor or optometrist.
  • 304.17C-120 Prescription eye drops coverage to include refills and additional bottle if conditions met.
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