| (a) Except as provided in subsection (c) of this section,
the grant of express authority of a provider for access to their fee
schedules cannot be presumed for any line of business for the purposes
of compliance with Insurance Code §1458.101.
(b) The contracting entity must notify the provider
about all applicable fee schedules, but such notification is not to
be, and must not be, construed as:
(1) prohibiting a provider network contracting entity
from only contracting with providers who agree to all fee schedules;
or
(2) requiring providers to agree to all fee schedules.
(c) For purposes of compliance with Insurance Code
§1458.101, a provider's express authority is presumed if:
(1) the provider network contract is in existence before
September 1, 2013;
(2) on the first renewal after September 1, 2013, the
contracting entity sends a written renewal notice by United States
mail to the provider;
(3) the notice described by paragraph (2) of this subsection:
(A) contains a statement that failure to timely respond
serves as assent to the renewal;
(B) contains separate signature lines for each line
of business applicable to the contract; and
(C) specifies the separate fee schedule for each line
of business applicable to the contract, described in any reasonable
manner and which may be provided electronically; and
(4) the provider fails to respond within 60 days of
receipt of the notice and has not objected to the renewal.
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