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§ 991.2112. Financial incentives prohibition

Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 40 P.S. InsuranceEffective: January 1, 2024

Purdon's Pennsylvania Statutes and Consolidated Statutes
Title 40 P.S. Insurance (Refs & Annos)
Chapter 2. Insurance Companies (Refs & Annos)
Article XXI. Quality Health Care Accountability and Protection (Refs & Annos)
(b) Insurer and MA and Chip Managed Care Plan Requirements (Refs & Annos)
Effective: January 1, 2024
40 P.S. § 991.2112
§ 991.2112. Financial incentives prohibition
No insurer or MA or CHIP managed care plan shall use any financial incentive that compensates a health care provider for providing less than medically necessary and appropriate care to a covered person or enrollee. Nothing in this section shall be deemed to prohibit an insurer or MA or CHIP managed care plan from using a capitated payment arrangement or other risk-sharing arrangement.

Credits

1921, May 17, P.L. 682, No. 284, § 2112, added 1998, June 17, P.L. 464, No. 68, § 1, effective Jan. 1, 1999. Amended 2022, Nov. 3, P.L. 2068, No. 146, § 1, effective Jan. 1, 2024.
40 P.S. § 991.2112, PA ST 40 P.S. § 991.2112
Current through Act 10 of the 2024 Regular Session. Some statute sections may be more current, see credits for details.
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