{"data":{"id":"us-ms/miss.-code-ann.-83-41-403","jurisdiction":"us-ms","citation":"Miss. Code Ann. § 83-41-403","heading":"Definitions.","body":"As used in this article:\n(a) “Department” means the Mississippi Department of Insurance.\n(b) “Managed care plan” means a plan operated by a managed care entity as described in subparagraph (c) that provides for the financing and delivery of health care services to persons enrolled in such plan through:\n(i) Arrangements with selected providers to furnish health care services;\n(ii) Explicit standards for the selection of participating providers;\n(iii) Organizational arrangements for ongoing quality assurance, utilization review programs and dispute resolution; and\n(iv) Financial incentives for persons enrolled in the plan to use the participating providers, products and procedures provided for by the plan.\n(c) “Managed care entity” includes a licensed insurance company, hospital or medical service plan, health maintenance organization (HMO), an employer or employee organization, or a managed care contractor as described in subparagraph (d) that operates a managed care plan.\n(d) “Managed care contractor” means a person or corporation that:\n(i) Establishes, operates or maintains a network of participating providers;\n(ii) Conducts or arranges for utilization review activities; and\n(iii) Contracts with an insurance company, a hospital or medical service plan, an employer or employee organization, or any other entity providing coverage for health care services to operate a managed care plan.\n(e) “Participating provider” means a physician, hospital, pharmacy, pharmacist, dentist, nurse, chiropractor, optometrist, or other provider of health care services licensed or certified by the state, that has entered into an agreement with a managed care entity to provide services, products or supplies to a patient enrolled in a managed care plan.","path":["Title 83. Insurance","Chapter 41. Hospital and Medical Service Associations and Contracts","Article 9. Patient Protection Act of 1995."],"source_url":"https://archive.org/download/gov.ms.code.ann.2018/release78.2020.07.08/gov.ms.code.title.83.odt","current_through":"2020-07-08","vintage":"Mississippi Code Release 78 (2020-07), retrieved 2026-09-17","retrieved_at":"2026-10-27T05:54:33Z","sha256":"d2ababb4d9ef78945792e3c05c84888539f763263c8ca8806ff8212f4f6dcbae","source_id":"us-ms","stale":false,"prev":"us-ms/miss.-code-ann.-83-41-401","next":"us-ms/miss.-code-ann.-83-41-405","notices":[{"id":"open-us-law","title":"Open US Law compilation","text":"Compilation CC BY 4.0, Open US Law (Vaquill AI). GroundRules uses only the releases published under CC BY 4.0: from v2026.09 the compilation is licensed CC BY-NC 4.0, and GroundRules does not use those releases. Each affected row names its release in its vintage label. GroundRules parsed and filtered the compilation to retain enacted text.","url":"https://huggingface.co/datasets/vaquill/open-us-law","license_url":"https://creativecommons.org/licenses/by/4.0/"},{"id":"pro-ms","title":"Mississippi Release 78 supplement","text":"Mississippi electronic product files were republished by Public.Resource.Org under a public-domain dedication. GroundRules uses enacted text from Release 78 only as a labeled supplement to the newer Open US Law rows.","url":"https://archive.org/details/gov.ms.code.ann.2018"}]},"notice":"GroundRules: Original legal text. Not legal advice."}