(1) As used in this section: (a) "Base rate" means the same as that term is defined in Section 53-2d-503. (b) "Medication maximum cost" means the same as that term is defined in Section 53-2d-503. (2) For a mileage rate established in a rule created under Section 53-2d-503, a health benefit plan shall accept a correctly charged mileage rate as an allowable expense for a claim. (3) For claims made under Section 53-2d-503, a health benefit plan shall accept a correctly charged amount: (a) that is equal to the base rate as an allowable expense; and (b) that is equal to the medication maximum cost as an allowable expense for a provided medication. (4) A health benefit plan shall make a payment for claims described in this section directly to the provider, including an out-of-network provider.
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