LD 1241
pg. 13
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LR 1344
Item 1

 
board, the professional association must be chosen by majority
vote of the appropriate category of providers.

 
4.__Discrimination.__A participating provider may not refuse
to provide services to a plan member on the basis of race,
religious creed, color, national origin, ancestry, physical or
mental disability, health status, medical condition, marital
status, gender, sexual orientation, age, wealth or any other
basis prohibited by the laws of this State.__This subsection may
not be construed to require a provider to perform a particular
service if the particular service is outside the provider's scope
of practice or if the provider asserts a religious or
conscientious objection to providing the particular service.

 
5.__Provision of information by participating provider.__A
participating provider shall make information available to the
board and permit examination of the provider's records by the
board as necessary for the purposes of this chapter.

 
6.__Nonparticipating providers.__Except as provided in section
9804, providers not participating in the plan may not be
reimbursed by the plan.

 
§9807.__Health plan administrator

 
Pursuant to rules adopted by the board, the board shall
solicit bids from companies or nonprofit organizations to act as
the administrator for the plan.__The board shall select the
administrator based on the price and quality of the
administrator's proposal, including the administrator's ability
to implement the health plan in accordance with the requirements
of this chapter.__The board may not enter into a contract with
the administrator for a term longer than 5 years.

 
1.__Duties.__Consistent with the requirements of this chapter,
the administrator has the following duties:

 
A.__To administer the health plan for all claims for
services covered under the plan;

 
B.__To provide for timely payments to participating
providers as required under this chapter;

 
C.__To solicit bids for prescription drug contracts in order
to achieve the lowest possible cost for drugs covered under
the plan;

 
D.__To negotiate with providers and provider associations to
set reimbursement levels and other terms of participation in
the plan;


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