reglab/housing_qa huggingface dataset:
DC Code § 31-2714 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 27 - Regulation of Casualty and Other Insurance Rates|§ 31-2714. Exemptions and limitations

(a) An insurer shall not be required to file with, or to receive approval from, the Commissioner, for rates and policy forms used in the insurance of exempt commercial risks. (b) The filing and review exemption set forth in subsection (a) of this section shall not apply to workers’ compensation and employer’s liability policies and rates. (c)(1) All policies issued under this chapter shall contain a notice to the insured that the rate and policy form are not subject to the filing, review, and approval requirements of the Commissioner. (2) An insurer providing a policy under this chapter shall, at the time of entering into the policy agreement and annually thereafter, on a form to be prescribed by the Commissioner, which form clearly sets forth the standards of this chapter; the right of the policyholder to obtain regulatory review under this chapter; the effects of the waiver of the regulatory review; and any other information the Commissioner considers useful; and obtain a written certification signed by the policyholder certifying that the policyholder: (A) Employs a certified or qualified risk manager or placed the business through a licensed insurance producer or otherwise meets the criteria of an exempt commercial risk; (B) Is aware that the policy being purchased is not subject to initial regulatory review or approval of rates and forms; and (C) Agrees to the use of the exempt rates and forms by its insurer. (3) The policyholder certification shall be filed with, and retained by, the insurance company issuing coverage to the policyholder. An insurer issuing policies under this section shall provide the number of exempt policyholders annually to the Commissioner. (d) If any provision of this section conflicts with any other law in the District, this section shall govern.  (May 20, 1948, 62 Stat. 242, ch. 324, § 14; as added May 5, 2001, D.C. Law 13-299, § 2(b), 48 DCR 2211; Oct. 19, 2002, D.C. Law 14-213, § 21, 49 DCR 8140.)  Effect of Amendments D.C. Law 14-213 validated a previously made technical change in directory language of D.C. Law 13-299 which required no change in text.
DC Code § 31-2801 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 28 - Access to Emergency Medical Services|§ 31-2801. Definitions

For the purposes of this chapter, the term: (1) “Ancillary services” means standard medical procedures that are reasonably necessary for the diagnosis and treatment of a patient. (2) “Emergency services” means: (A) Health care services furnished in the emergency department of a hospital for the treatment of a medical emergency; (B) Ancillary services routinely available to the emergency department of a hospital for the treatment of a medical emergency; and (C) Emergency medical services transportation. (3) “Medical emergency” means the sudden onset or sudden worsening of a medical condition that manifests itself by symptoms of sufficient severity, including severe pain, that the absence of immediate medical attention could reasonably be expected by a prudent lay person, who possesses an average knowledge of health and medicine, to result in: (A) Placing the patient’s health in serious jeopardy; (B) Serious impairment to bodily functions; or (C) Serious dysfunction of any bodily organ or part.  (Sept. 11, 1998, D.C. Law 12-145, § 2, 45 DCR 3785.)  Prior Codifications 1981 Ed., § 35-4801.
DC Code § 31-2802 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 28 - Access to Emergency Medical Services|§ 31-2802. Covered services

(a)(1) All health insurers, hospitals or medical services corporations, and health maintenance organizations shall reimburse for emergency services that are due to a medical emergency. (2) Reimbursement for pre-hospital medical care and transport delivered pursuant to paragraph (1) of this subsection by the Fire and Emergency Medical Services Department ("Department") or a third party contracted by the District to provide such services pursuant to § 5-401(b), shall be at the fee rate authorized by the Council pursuant to § 5-416(a). (3) This subsection shall not apply to any group health plan or multiple employer welfare arrangement to the extent the plan or arrangement is not subject to state insurance regulation under section 514 of the Employee Retirement Income Security Act of 1974, approved September 2, 1974 (88 Stat. 897; 29 U.S.C. § 1144). (b) A hospital emergency department or emergency medical service transporter shall provide a health insurer, hospital or medical services corporation, or health maintenance organization with any claim for reimbursement of services, and information on the presenting symptoms of the insured as well as the services provided. (c) A health insurer, hospital or medical services corporation, or health maintenance organization shall consider both the presenting symptoms and the services provided in processing a claim for reimbursement of emergency services. (d) A health insurer, hospital or medical services corporation, or health maintenance organization may not deny reimbursement, except for co-payments, deductibles, and co-insurance, for the provision of emergency services that are due to a medical emergency solely because the member failed to obtain pre-authorization for emergency services from the health insurer, hospital or medical services corporation, or health maintenance organization.  (Sept. 11, 1998, D.C. Law 12-145, § 3, 45 DCR 3785; Dec. 13, 2017, D.C. Law 22-33, § 3022, 64 DCR 7652.)  Prior Codifications 1981 Ed., § 35-4802. Applicability Section 3024 of D.C. Law 22-33 provided that the amendments made to this section by section 3022 of D.C. Law 22-33 shall apply to all health benefit plans issued or renewed in the District 90 or more days after December 13, 2017.  Emergency Legislation  For temporary (90 days) amendment of this section, see § 3022 of Fiscal Year 2018 Budget Support Congressional Review Emergency Act of 2017 (D.C. Act 22-167, Oct. 24, 2017, 64 DCR 10802).   For temporary (90 days) amendment of this section, see § 3022 of Fiscal Year 2018 Budget Support Emergency Act of 2017 (D.C. Act 22-104, July 20, 2017, 64 DCR 7032).
DC Code § 31-2991 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 29A - Closed Malpractice Claims|§ 31-2991. Closed claim analysis

(a) Within 180 days of march 14, 2007, the Mayor shall submit legislation to the Council for the establishment of a database of closed obstetrician/gynecologist malpractice claims reports to be submitted by providers of medical malpractice insurance. (b) The legislation shall include a plan which shall: (A) Contain provisions to identify trends and develop recommendations for preventative action for adverse Obstetrician/Gynecologist events; (B) Ensure dissemination of best practices among Obstetrician/Gynecologist practitioners and facilities and shall include provisions for ensuring the implementation of these practices; and (C) Include provisions to study recommendations based on closed Obstetrician/Gynecologist malpractice claims in other jurisdictions.  (Mar. 14, 2007, D.C. Law 16-263, § 402, 54 DCR 807.)
DC Code § 31-2993.02 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 29B - Clinical Trials Insurance Coverage|§ 31-2993.02. Covered trials

(a) A health insurer shall not limit or deny coverage, or impose additional conditions on the payment for the coverage, of routine patient care costs of items, drugs, and services furnished to a qualified individual in connection with participation in an approved clinical trial. A health insurer shall not be required to pay for costs of items, services, or drugs that are customarily provided by the sponsors of an approved clinical trial. (b) In the case of health care services provided by a participating provider, the payment rate shall be at the network negotiated rate, based on the member’s plan design. In case of a non-participating provider, the payment shall be at the rate that the member’s plan would otherwise pay to a non-participating provider for the same services, less any applicable co-payments and deductibles.  (June 5, 2008, D.C. Law 17-166, § 3, 55 DCR 5174.)
DC Code § 31-2993.03 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 29B - Clinical Trials Insurance Coverage|§ 31-2993.03. Right to file grievance

This chapter shall not limit, prohibit, or modify a qualified individual’s right to: (1) File a grievance and use an independent review process, if available; or (2) Use the independent medical review system.  (June 5, 2008, D.C. Law 17-166, § 4, 55 DCR 5174.)
DC Code § 31-2995.01 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 29C - Chemotherapy Pill Coverage|§ 31-2995.01. Definitions

For the purposes of this chapter, the term: (1) “Group health plan” means an employee welfare plan (as defined in section 3(1) of the Employee Retirement Income Security Act of 1974, approved September 2, 1974 (88 Stat. 829; 29 U.S.C. § 1002(1)), to the extent that the plan provides medical care and includes items and services paid for as medical care to employees or their dependents (as defined under the terms of the plan) directly or through insurance, reimbursement, or otherwise. (2) “Health insurance coverage” means benefits consisting of medical care (provided directly, through insurance or reimbursement, or otherwise and includes items and services paid for as medical care) under any hospital or medical service policy or certificate, hospital, or medical service plan contract, or health maintenance organization contract offered by a health insurer. (3) “Health insurer” means any person that provides one or more health benefit plans or insurance in the District, including an insurer, a hospital and medical services corporation, a fraternal benefit society, a health maintenance organization, a multiple employer welfare arrangement, or any other person providing a plan of health insurance subject to the authority of the Commissioner of the Department of Insurance, Securities, and Banking. (4) “Individual health plan” means a plan offering health insurance coverage offered to individuals other than in connection with a group health plan.  (Dec. 17, 2009, D.C. Law 18-98, § 2, 56 DCR 8530.)
DC Code § 31-2995.02 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 29C - Chemotherapy Pill Coverage|§ 31-2995.02. Chemotherapy pill coverage

(a) An individual health plan or group health plan, and a health insurer offering health insurance coverage that provides coverage for prescription drugs, shall provide health insurance coverage for prescribed, orally administered anticancer medication used to kill or slow the growth of cancerous cells and the person receiving such prescribed medication shall have the option of having it dispensed at any appropriately licensed pharmacy. (b) The health insurance coverage provided under this section shall be on a basis no less favorable than coverage provided for intravenously administered or injected cancer medications, for purposes of determining deductibles, benefit year or lifetime durational limits, benefit year or lifetime dollar limits, lifetime episodes or treatment limits, copayment and coinsurance factors, and benefit year maximum for deductibles and copayments and coinsurance factors.  (Dec. 17, 2009, D.C. Law 18-98, § 3, 56 DCR 8530.)
DC Code § 31-2995.03 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 29C - Chemotherapy Pill Coverage|§ 31-2995.03. Applicability to group health plans

This chapter shall apply to group health plans for years beginning on or after December 17, 2009.  (Dec. 17, 2009, D.C. Law 18-98, § 4, 56 DCR 8530.)
DC Code § 31-2996.02 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 29D - Dependent Health Insurance|§ 31-2996.02. Dependent child coverage

(a) A group health plan or an individual health plan, and a health insurer offering health insurance coverage that provides coverage for dependent children, that delivers, issues for delivery, amends, or renews a health insurance policy in the District of Columbia shall make health insurance coverage available and, if requested by the policyholder, extend coverage to any dependent child of a policyholder until the dependent child is no longer a dependent child. (b) The health insurance coverage shall provide: (1) The same health insurance coverage benefits to a dependent child that are available to any other covered dependent; and (2) Health insurance coverage benefits to a dependent child at the same rate or premium applicable to any other covered dependent. (c) Nothing in this chapter shall be construed to require: (1) Coverage for services provided to a dependent before October 26, 2010; or (2) That an employer or other group policyholder pay all or part of the cost of coverage for a dependent as provided pursuant to this section.  (Oct. 26, 2010, D.C. Law 18-252, § 3, 57 DCR 8064.)  Emergency Legislation For temporary (90 day) addition, see § 3 of Health Insurance for Dependents Emergency Act of 2010 (D.C. Act 18-384, April 29, Temporary Legislation Section 3 of D.C. Law 18-203 added a section to read as follows: “Sec. 3. Dependent child coverage. “(a) A group health plan or an individual health plan, and a health insurer offering health insurance coverage that provides coverage for dependent children, that delivers, issues for delivery, amends, or renews a health insurance policy in the District of Columbia shall make health insurance coverage available and, if requested by the policyholder, extend health insurance coverage to any dependent child of a policyholder until the dependent child is no longer a dependent child. “(b) The health insurance coverage shall provide: “(1) The same health insurance coverage benefits to a dependent child that are available to any other covered dependent; and “(2) Health insurance coverage benefits to a dependent child at the same rate or premium applicable to any other covered dependent. “(c) Nothing in this act shall be construed to require: “(1) Coverage for services provided to a dependent before the effective date of this act; or “(2) That an employer or other group policyholder pay all or part of the cost of coverage for a dependent as provided pursuant to this section.” Section 6(b) of D.C. Law 18-203 provided that the act shall expire after 225 days of its having taken effect.
DC Code § 31-2996.03 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 29D - Dependent Health Insurance|§ 31-2996.03. Limitations on other coverage

This chapter shall not limit or alter any right to dependent coverage or to the continuation of coverage that is otherwise provided for in the District of Columbia.  (Oct. 26, 2010, D.C. Law 18-252, § 4, 57 DCR 8064.)  Emergency Legislation For temporary (90 day) addition, see § 4 of Health Insurance for Dependents Emergency Act of 2010 (D.C. Act 18-384, April 29, 2010, 57 DCR 3835). Temporary Legislation Section 4 of D.C. Law 18-203 added a section to read as follows: “Sec. 4. Limitations on other coverage. ”This act shall not limit or alter any right to dependent coverage or to the continuation of coverage that is otherwise provided for in the District of Columbia.” Section 6(b) of D.C. Law 18-203 provided that the act shall expire after 225 days of its having taken effect.
DC Code § 31-3001 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 30 - Diabetes Health Insurance Coverage|§ 31-3001. Definitions

For the purposes of this chapter, the term: (1) “Health benefit plan” means an accident and health insurance policy or certificate, hospital and medical services corporation contract, health maintenance organization subscriber contract, plan provided by a multiple employer welfare arrangement, or plan provided by another benefit arrangement. The term “health benefit plan” shall not mean accident only, credit, or disability insurance; coverage of medicare services or federal employee health plans under contracts with the United States Government; medicare supplement or long-term care insurance; specified disease insurance; hospital confinement indemnity coverage; limited benefit health coverage; coverage issued as a supplement to liability insurance; insurance arising out of a workers’ compensation or similar law; automobile medical payment insurance; medical expense and loss of income benefits; or insurance under which benefits are payable with or without regard to fault and which is statutorily required to be contained in a liability insurance policy or equivalent self-insurance. (2) “Health insurer” means a person that provides one or more health benefit plans or insurance in the District of Columbia, including an insurer, a hospital and medical services corporation, a fraternal benefit society, a health maintenance organization, a multiple employer welfare arrangement, or any other person providing a plan of health insurance subject to the authority of the Commissioner of the Department of Insurance, Securities, and Banking. (3) “Insured” means a person covered by a health benefit plan.  (Oct. 21, 2000, D.C. Law 13-175, § 2, 47 DCR 6832; June 11, 2004, D.C. Law 15-166, § 4(q), 51 DCR 2817.)  Section References This section is referenced in § 31-2803 and § 31-3161. Effect of Amendments D.C. Law 15-166, in par. (2), substituted “Department of Insurance, Securities, and Banking” for “Department of Insurance and Securities Regulation”. Emergency Legislation For temporary (90 day) amendment of section, see § 4(q) of Consolidation of Financial Services Emergency Amendment Act of 2004 (D.C. Act 15-381, February 27, 2004, 51 DCR 2653).
DC Code § 31-3002 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 30 - Diabetes Health Insurance Coverage|§ 31-3002. Payable benefits

A health benefit plan shall provide coverage for the equipment, supplies, and other outpatient self-management training and education, including medical nutritional therapy, for the treatment of insulin-dependent diabetes, insulin-using diabetes, gestational diabetes, and non-insulin using diabetes if prescribed by a health care professional legally authorized to prescribe such item.  (Oct. 21, 2000, D.C. Law 13-175, § 3, 47 DCR 6832.)
DC Code § 31-3003 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 30 - Diabetes Health Insurance Coverage|§ 31-3003. Nondiscrimination

No health insurer shall: (1) Require an insured to pay a higher deductible, copayment, or coinsurance; require a longer waiting period; or impose any other condition for coverage of any of the benefits set forth in this chapter other than is required for other benefits covered by the insured’s health benefit plan; (2) Refuse to issue a health benefit plan solely because an applicant may use any of the benefits covered by this chapter; (3) Cancel a health benefit plan solely because an insured has used any of the benefits covered by this chapter; (4) Offer to pay any type of material inducement or financial incentive to an insured to discourage the insured from using any of the benefits covered by this chapter; or (5) Offer to pay any type of financial or other material incentive to a health care provider to deny, reduce, withhold, limit, or delay to an insured any of the benefits covered by this chapter.  (Oct. 21, 2000, D.C. Law 13-175, § 4, 47 DCR 6832.)
DC Code § 31-3004 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 30 - Diabetes Health Insurance Coverage|§ 31-3004. Applicability

(a) The requirements of this chapter shall apply to all health benefit plans issued, delivered, renewed, or reissued on the 91st day after October 21, 2000. (b) All health benefit plans other than the health benefit plans specified in subsection (a) of this section shall comply with the requirements of this chapter within 180 days after the date specified in subsection (a) of this section.  (Oct. 21, 2000, D.C. Law 13-175, § 5, 47 DCR 6832.)
DC Code § 31-3012 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 30A - Discontinuance of Class of Health Insurance Policies|§ 31-3012. Rules

The Mayor, pursuant to subchapter I of Chapter 5 of Title 2 [§ 2-501 et seq.], shall issue rules to implement the provisions of this chapter.  (Apr. 8, 2011, D.C. Law 18-360, § 403, 58 DCR 896.)
DC Code § 31-3013 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 30A - Discontinuance of Class of Health Insurance Policies|§ 31-3013. Application

This chapter shall apply to policies and certificates of insurance that are health benefit plans as defined under § 31-3271(4) that are issued 90 days after April 8, 2011. This chapter shall not apply to short-term limited duration health benefit plans.  (Apr. 8, 2011, D.C. Law 18-360, § 404, 58 DCR 896.)
DC Code § 31-3104 (2021)
2021 District of Columbia Code|Title 31 - Insurance and Securities|Chapter 31 - Drug Abuse, Alcohol Abuse, and Mental Illness Insurance Coverage|§ 31-3104. Mental illness benefits

(a) Covered benefits for services set forth in this section shall be limited to coverage of treatment of clinically significant mental illnesses identified in the most recent edition of the International Classification of Diseases or of the Diagnostic and Statistical Manual of the American Psychiatric Association. (b) Treatment under this section shall be covered pursuant to § 31-3102 for a minimum of 60 days per year for inpatient or residential care in a hospital or nonhospital residential facility, and at a minimum rate of 75% for the first 40 outpatient visits per year and at a minimum rate of 60% for any outpatient visits thereafter for that year.  (Feb. 28, 1987, D.C. Law 6-195, § 5, 34 DCR 491; Mar. 8, 2007, D.C. Law 16-242, § 2(d), 54 DCR 601.)  Prior Codifications 1981 Ed., § 35-2304. Section References This section is referenced in § 31-3102, § 31-3105, § 31-3106, and § 31-3110. Effect of Amendments D.C. Law 16-242, in subsec. (b), substituted “60 days” for “45 days”.