CHAPTER 352


97-H 6282
Effective Without the Governor's Signature
Jul. 8, 1997


AN ACT RELATING TO INSURANCE

It is enacted by the General Assembly as follows:

SECTION 1. Chapter 27-41 of the General Laws entitled "Health Maintenance Organizations" is hereby amended by adding thereto the following section:

{ADD 27-41-14.1. Prohibition against restraint on provider -- Patient communications. -- ADD} {ADD No health maintenance organization shall refuse to contract with or compensate for covered services an otherwise eligible health care provider solely because such provider has in good faith communicated with one (1) or more of his or her current, former or prospective patients regarding the provisions, terms, requirements, restrictions or other treatment options not provided by the health maintenance organization as well as of the health maintenance organization's products and/or services as they relate to the needs of such provider's patients. By way of illustration only, and without limiting the protections afforded herein, the communications within this section may involve hospital stays, emergency room use, and referral to specialists. Any provision contained in any contract between a health maintenance organization and a health care provider which violates the provisions of this section shall be null and void, and any attempt by a health maintenance organization to enforce such a provision shall subject the health maintenance organization to assessment of a penalty of up to five thousand dollars ($5,000). Such penalties shall be enforced by the consumer protection division of the department of the attorney general in the district court. ADD}

SECTION 2. This act shall take effect upon passage.



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