TITLE 41

INSURANCE

CHAPTER 18

THE INSURANCE CONTRACT

41-1847.  Assignment of health insurance contracts. (1) No insurer, as defined in section 41-5601, Idaho Code, shall assign the benefits of any contract with a practitioner or facility, as defined in section 41-5601, Idaho Code, that contains an agreement by the practitioner or facility to provide services to a patient covered by the insurer at a fee which is discounted from that practitioner’s or facility’s usual and customary fee, unless the contract between the insurer and the practitioner or facility, in conspicuous and plain language, specifically permits the contract to be assigned.

(2)  An insurer shall send prompt written or electronic notice to the practitioner or facility, in conformance with the notice provisions of the contract between the insurer and the practitioner or facility, of each assignment it makes that is permitted by subsection (1) of this section. The notice shall identify the name and principal business address of each assignee.

(3)  An assignment in violation of this section shall be void. The director shall enforce the provisions of this section and shall review and, if appropriate, investigate complaints received by the department related to noncompliance with the provisions of this section. If the director determines an insurer has violated the provisions of this section, the director may impose an administrative fine not to exceed five thousand dollars ($5,000) based upon an enforcement action. The director shall not suspend or revoke an insurer’s certificate of authority for violation of this section. This section shall not create a private cause of action by or on behalf of a beneficiary or practitioner or facility against an insurer.

History:

[41-1847, added 2008, ch. 139, sec. 1, p. 400.]