HB 565 Summary

• Amends Section 41-2872 to clarify that insurance companies may refuse to contract with health care providers based on qualifications, terms, conditions, practice standards, and quality requirements only.

• Requires insurance companies to provide written notice of contract breaches and a reasonable cure period before termination or non-renewal, except for willful breach, fraud, or breaches posing immediate danger to public health or safety.

• Amends Section 41-3927 to impose identical requirements on managed care organizations regarding provider contracts, grievance procedures, and prohibition on denying services based solely on provider group membership or type of services provided.

• Prohibits managed care organizations from requiring providers to agree to deny non-covered services, restrict treatment at member request, adjust rates to match other payors, or disclose contractual rates from other payors.

• Exempts self-insured employee benefit plans covered by stop-loss insurance from these requirements, consistent with federal ERISA provisions.