441.73.1 Definitions. |
|
|
|
441.73.2 Contracts with a managed care organization. |
|
|
|
441.73.3 Enrollment. |
|
|
|
441.73.4 Disenrollment process. |
|
|
|
441.73.5 Covered services. |
|
|
|
441.73.6 Amount, duration and scope of services. |
|
|
|
441.73.7 Emergency services. |
|
|
|
441.73.8 Access to service. |
|
|
|
441.73.9 Incident reporting. |
|
|
|
441.73.10 Discharge planning. |
|
|
|
441.73.11 Level of care assessment and annual reviews. |
|
|
|
441.73.12 Appeal of managed care organization actions. |
|
|
|
441.73.13 Appeal to department. |
|
|
|
441.73.14 Continuation of benefits. |
|
|
|
441.73.15 Grievances. |
|
|
|
441.73.16 Written record. |
|
|
|
441.73.17 Information concerning procedures relating to the review of managed care organization decisions and actions. |
|
|
|
441.73.18 Records and reports. |
|
|
|
441.73.19 Audits. |
|
|
|
441.73.20 Marketing. |
|
|
|
441.73.21 Enrollee education. |
|
|
|
441.73.22 Payment to the managed care organization. |
|
|
|
441.73.23 Claims payment by the managed care organization. |
|
|
|
441.73.24 Quality assurance. |
|
|
|
441.73.25 Certifications and program integrity. |
|
|
|