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Current as of January 01, 2025 | Updated by Findlaw Staff
(a) Any law to the contrary notwithstanding, any corporation or limited liability company may establish, maintain and operate a health maintenance organization upon receipt of a certificate of authority to do so in accordance with this act.
(b) Such health maintenance organizations shall:
(1) Provide either directly or through arrangements with others, basic health services to individuals enrolled;
(2) Provide either directly or through arrangements with other persons, corporations, institutions, associations or entities, basic health services; and
(3) Provide physicians' services (i) directly through physicians who are employes of such organization, (ii) under arrangements with one or more groups of physicians (organized on a group practice or individual practice basis) under which each such group is reimbursed for its services primarily on the basis of an aggregate fixed sum or on a per capita basis, regardless of whether the individual physician members of any such group are paid on a fee-for-service or other basis or (iii) under similar arrangements which are found by the secretary to provide adequate financial incentives for the provision of quality and cost-effective care.
Cite this article: FindLaw.com - Pennsylvania Statutes Title 40 P.S. Insurance § 1554. Services which shall be provided - last updated January 01, 2025 | https://codes.findlaw.com/pa/title-40-ps-insurance/pa-st-sect-40-1554/
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