| All health maintenance organizations providing payment or |
| reimbursement for diagnosis or treatment of a condition or a |
| complaint by a licensed health care practitioner must accept the |
| current standardized claim form for professional services |
| approved by the Federal Government and submitted electronically. |
| All health maintenance organizations providing payment or |
| reimbursement for diagnosis or treatment of a condition or a |
| complaint by a licensed hospital must accept the current |
| standardized claim form for professional or facility services, as |
| applicable, approved by the Federal Government and submitted |
| electronically. A health maintenance organization may not be |
| required to accept a claim submitted on a form other than the |
| applicable form specified in this section and may not be required |
| to accept a claim that is not submitted electronically, except |
| from a health care practitioner who is exempt pursuant to Title |
| 24, section 2985. All services provided by a health care |
| practitioner in an office setting must be submitted on the |
| standardized federal form used by noninstitutional providers and |
| suppliers.__Services in a nonoffice setting may be billed as |
| negotiated between the health maintenance organization and health |
| care practitioner. For purposes of this section, "office setting" |
| means a location where the health care practitioner routinely |
| provides health examinations, diagnosis and treatment of illness |
| or injury on an ambulatory basis whether or not the office is |
| physically located within a facility. |