13-5b - Integrated Health System Fair Practices Act

Title 13 > 13-5b

Sections (3)

13-5b-101 - Title.

This chapter is known as the “Integrated Health System Fair Practices Act.”

13-5b-102 - Definitions.

For purposes of this chapter: 13-5b-102(1) “Affiliate” means an organization that directly or indirectly through one or more intermediaries controls, is controlled by, or is under common control with another organization. 13-5b-102(2) “Integrated health system” means an organization that directly, or through an affiliate or subsidiary:

owns and operates one or more hospitals in the state; and offers health insurance to residents of the state. 13-5b-102(3) “Subsidiary” means an affiliate controlled:

by a specified person; directly or indirectly; and through one or more intermediaries.

13-5b-103 - Contract negotiation standards.

13-5b-103(1) An integrated health system shall prohibit any employee or independent contractor of any division, subsidiary, or affiliate engaged in the business of health insurance from negotiating contracts on behalf of the integrated health care system’s health care facilities, subject to licensing under Title 26B, Chapter 2, Part 2, Health Care Facility Licensing and Inspection, with any other licensed health insurer in the state. 13-5b-103(2) An integrated health system shall prohibit the disclosure of contract pricing terms between the integrated health care system’s health care facilities and other health insurers with the integrated health care system’s divisions, subsidiaries, or affiliates which are engaged in the business of health insurance.