1728

(a) Notwithstanding the provisions of this chapter, any physician who is a member of a Preferred Provider Organization ('PPO') which meets, the requirements set forth below, shall not be subject to the requirements of section 1724 of this title:\n(1) The PPO physician shall require no more than a reasonable co- payment by the patient at the time the services are rendered, which co-payment shall not exceed co-payments generally required under other health insurance plans;\n(2) The PPO shall require the health care provider to file claims with the insurer for payment and shall prohibit the practice of billing the patient directly for any covered services or for any costs in excess of the schedule of fees agreed upon and paid by the insurer;\n(3) The PPO shall cancel the membership of any individual health care provider who fails to adhere to any of the requirements of this section or any reasonable rules and regulations of the PPO which are not in conflict herewith;\n(4) The PPO shall include within its network no less than 25% of the health care providers in each of the St. Thomas-St. John and the St.

d regulations of the PPO which are not in conflict herewith;\n(4) The PPO shall include within its network no less than 25% of the health care providers in each of the St. Thomas-St. John and the St. Croix districts, representing the major medical specialties;\n(5) The PPO shall be available to any insurers offering health insurance plans.\n(b) Any insurer offering a recognized health insurance plan in the Virgin Islands shall offer as part of its plan access to a PPO which meets the requirements of subsection (a).