376.778. Payment direct to public hospitals or clinics with or without assignment, when--provisions required in contracts.
Payment direct to public hospitals or clinics with or withoutassignment, when--provisions required in contracts.
376.778. 1. As used in this section, the following wordsmean:
(1) "Assignment", authorization by an insured to pay healthinsurance benefits directly to the provider of services;
(2) "Claim", forms, bills, itemized charges and otherdocuments required by an insurance company or health servicescorporation to pay benefits under a contract, and a notice thatdirect payment is demanded pursuant to this section;
(3) "Contract", an individual or group health insurancepolicy or contract providing coverage on an expense incurredbasis issued by an insurance company or a health servicescorporation doing business in this state;
(4) "Insured", a person covered under a contract issued byan insurance company or health services corporation.
2. Every contract subject to this section shall contain aprovision whereby the benefits payable thereunder to an insuredshall be paid, with or without an assignment from the insured, topublic hospitals or clinics for services and supplies provided tothe insured if a proper claim is submitted by the public hospitalor clinic. No benefits shall be paid under this section to thepublic hospital or clinic if such benefits have been paid to theinsured prior to receipt of the claim by the insurance company orhealth services corporation. Payment to the public hospital orclinic of benefits pursuant to this section shall discharge theinsurance company or health services corporation from allliability to the insured to the extent of the benefits so paid.Nothing in this section shall be construed to require payment ofbenefits for the same services or supplies to both the insuredand the public hospital or clinic.
3. This section shall apply to every contract issued,amended, or renewed after September 28, 1983, by an insurancecompany or a health services corporation doing business in thisstate.
(L. 1983 H.B. 699 § 1)