| C.__The plan must pay for health care services provided to |
| plan members while they are out of the State.__The plan |
| member must have been out of the State temporarily for |
| reasons other than to obtain the health care services, or |
| the member must have obtained the health care services out |
| of the State for compelling reasons related to the |
| suitability of the services, the nature of the condition and |
| personal circumstances.__The agency shall establish and |
| operate a plan to pay for health care services provided to |
| plan members while they are out of the State.__The payments |
| must be made at the rates established by the agency for |
| comparable services provided by the plan in the State.__ |
| Charges in excess of the payment rates established in |
| accordance with this paragraph are the responsibility of the |
| plan member. |