Section 10175.5 Of Article 4. Payment And Proceeds From California Insurance Code >> Division 2. >> Part 2. >> Chapter 1. >> Article 4.
10175.5
. (a) No disability insurance contract with a physician and
surgeon, physician and surgeon group, or other licensed health care
practitioner shall contain any incentive plan that includes specific
payment made in any type or form, to a physician and surgeon,
physician and surgeon group, or other licensed health care
practitioner as an inducement to deny, reduce, limit, or delay
specific, medically necessary, and appropriate services provided with
respect to specific insureds or groups of insureds with similar
medical conditions.
(b) Nothing in this section shall be construed to prohibit payment
arrangements that are not tied to specific medical decisions
involving specific insureds or group of insureds with similar medical
conditions.