Article 7 - Standards
- § 1300.67 - Scope of Basic Health Care Services
- § 1300.67.003 - State Medical Loss Ratio Annual Report
- § 1300.67.005 - Essential Health Benefits
- § 1300.67.01 - Covid-19 Diagnostic Testing. [Repealed]
- § 1300.67.02 - Transfer of Enrollees Pursuant to a Public Health Order
- § 1300.67.04 - Language Assistance Programs
- § 1300.67.05 - Acts of War Exclusions
- § 1300.67.1 - Continuity of Care
- § 1300.67.1.3 - Block Transfer Filings
- § 1300.67.2 - Accessibility of Services
- § 1300.67.2.1 - Geographic Accessibility Standards
- § 1300.67.2.2 - Timely Access to Non-Emergency Health Care Services and Annual Timely Access and Network Reporting Requirements
- § 1300.67.2.3 - Timely Access Quality Assurance for Measurement Year 2022
- § 1300.67.3 - Standards for Plan Organization
- § 1300.67.4 - Subscriber and Group Contracts
- § 1300.67.8 - Contracts with Providers
- § 1300.67.10 - Discrimination Prohibited. [Repealed]
- § 1300.67.11 - Disclosure of Conflicts of Interest
- § 1300.67.12 - Contracts with Solicitor Firms
- § 1300.67.13 - Coordination of Benefits ("COB")
- § 1300.67.205 - Standard Prescription Drug Formulary Template
- § 1300.67.24 - Outpatient Prescription Drug Copayments, Coinsurance, Deductibles, Limitations and Exclusions
- § 1300.67.241 - Prescription Drug Prior Authorization or Step Therapy Exception Request Form Process
- § 1300.67.50 - Certain Medicare Supplement Contracts: Presumption of Unfairness. [Repealed]
- § 1300.67.51 - Medicare Supplement Contract Provisions. [Repealed]
- § 1300.67.52 - Medicare Supplement Additional Benefit Requirements. [Repealed]
- § 1300.67.53 - Medicare Supplement Minimum Aggregate Benefits. [Repealed]
- § 1300.67.55 - Medicare Supplement Reporting Requirements. [Repealed]
- § 1300.67.56 - Transitional Requirements for the Conversion of Medicare Supplement Contracts to Conform to Medicare Program Revisions. [Repealed]
- § 1300.67.57 - Format for Notices of Changes in Coverage. [Repealed]
- § 1300.67.58 - Participating Physician or Supplier Claims Form Requirement. (Compliance with Section 4081 of the Omnibus Budget Reconciliation Act of 1987) [Repealed]
- § 1300.67.59 - Format for Reporting Loss Ratio Experience. [Repealed]
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
- § 1300.67 - Scope of Basic Health Care Services
- § 1300.67.003 - State Medical Loss Ratio Annual Report
- § 1300.67.005 - Essential Health Benefits
- § 1300.67.01 - Covid-19 Diagnostic Testing. [Repealed]
- § 1300.67.02 - Transfer of Enrollees Pursuant to a Public Health Order
- § 1300.67.04 - Language Assistance Programs
- § 1300.67.05 - Acts of War Exclusions
- § 1300.67.1 - Continuity of Care
- § 1300.67.1.3 - Block Transfer Filings
- § 1300.67.2 - Accessibility of Services
- § 1300.67.2.1 - Geographic Accessibility Standards
- § 1300.67.2.2 - Timely Access to Non-Emergency Health Care Services and Annual Timely Access and Network Reporting Requirements
- § 1300.67.2.3 - Timely Access Quality Assurance for Measurement Year 2022
- § 1300.67.3 - Standards for Plan Organization
- § 1300.67.4 - Subscriber and Group Contracts
- § 1300.67.8 - Contracts with Providers
- § 1300.67.10 - Discrimination Prohibited. [Repealed]
- § 1300.67.11 - Disclosure of Conflicts of Interest
- § 1300.67.12 - Contracts with Solicitor Firms
- § 1300.67.13 - Coordination of Benefits ("COB")
- § 1300.67.205 - Standard Prescription Drug Formulary Template
- § 1300.67.24 - Outpatient Prescription Drug Copayments, Coinsurance, Deductibles, Limitations and Exclusions
- § 1300.67.241 - Prescription Drug Prior Authorization or Step Therapy Exception Request Form Process
- § 1300.67.50 - Certain Medicare Supplement Contracts: Presumption of Unfairness. [Repealed]
- § 1300.67.51 - Medicare Supplement Contract Provisions. [Repealed]
- § 1300.67.52 - Medicare Supplement Additional Benefit Requirements. [Repealed]
- § 1300.67.53 - Medicare Supplement Minimum Aggregate Benefits. [Repealed]
- § 1300.67.55 - Medicare Supplement Reporting Requirements. [Repealed]
- § 1300.67.56 - Transitional Requirements for the Conversion of Medicare Supplement Contracts to Conform to Medicare Program Revisions. [Repealed]
- § 1300.67.57 - Format for Notices of Changes in Coverage. [Repealed]
- § 1300.67.58 - Participating Physician or Supplier Claims Form Requirement. (Compliance with Section 4081 of the Omnibus Budget Reconciliation Act of 1987) [Repealed]
- § 1300.67.59 - Format for Reporting Loss Ratio Experience. [Repealed]