Health Insurance Payment Systems State Law Survey


This practice note is a 50-state survey addressing mandated coverage in healthcare insurance policies including changes following the full implementation of the federal Patient Protection and Affordable Care Act (PPACA), state provisions on mandated benefits reviews, independent/external reviews of coverage denials and claims, prohibitions, or restrictions to financial incentives to physicians, and requirements regarding premium rating types. The survey details laws and regulations in all 50 U.S. states, the District of Columbia, Puerto Rico, Guam, and the Virgin Islands.