(1) A person or entity shall not assign, allow access to, sell, rent, or give the person's or entity's rights to the health care provider's services pursuant to the person's or entity's contract unless the person or entity complies with the requirements of this section.
(2) A person or entity may assign, allow access to, sell, rent, or give his, her, or its rights to the health care provider's services pursuant to the person's or entity's contract if one of the following situations exists:
The third party accessing the health care provider's services under the contract is anemployer or other entity providing coverage for health care services to its employees or members and such employer or entity has, with the person or entity contracting with the health care provider, a contract for the administration or processing of claims for payment or service provided pursuant to the contract with the health care provider;
The third party accessing the health care provider's services under the contract is anaffiliate of, subsidiary of, or is under common ownership or control with the person or entity; or, is providing or receiving administrative services from the person or entity or an affiliate of, or subsidiary of, or is under common ownership or control with the person or entity; or
The health care contract specifically provides that it applies to network rental arrangements and states that it is for the purpose of assigning, allowing access to, selling, renting, or giving the person's or entity's rights to the health care provider's services.
(3) In addition to satisfying the requirements of subsection (2) of this section, a person or entity may assign, allow access to, sell, rent, or give his, her, or its rights under the contract to the services of the health care provider only if:
The individuals receiving services under the health care provider's contract are provided with appropriate identification stating where claims should be sent and where inquiries should be directed; and
The third party accessing the health care provider's services through the health careprovider's contract is obligated to comply with all applicable terms and conditions of the contract; except that a self-funded plan receiving administrative services from the person or entity or its affiliates shall be solely responsible for payment to the provider.
Source: L. 2010: Entire article amended with relocations, (HB 10-1332), ch. 300, p. 1423, § 1, effective May 26.
Editor's note: This section is similar to former § 25-37-101 (10) as it existed prior to 2010.