Ohio Admin. Code 4123-6-03.4 - MCO participation in the HPP - MCO certification
(A) Upon review by
and satisfactory to the bureau that the managed care organization has met
bureau certification standards, the bureau shall certify an MCO as eligible to
contract with the bureau to provide medical management and cost containment
services for injured workers and employers.
(B) MCO certification by the bureau shall be
for a period of two years. Upon approval by the
bureau, an MCO may expand its coverage area after the first year of
certification and every year thereafter.
(C) The bureau may certify any number of MCOs
for each county or statewide. Upon approval by the
bureau, an MCO may expand its coverage area after the first year of
certification and every year thereafter.
(D) The bureau shall maintain a current list
of all bureau certified MCOs. The list shall include the name and address of
each MCO and the counties in which the MCO is certified.
(E) An MCO may apply to the bureau for
recertification beyond the first two years of certification.
Notes
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.121, 4121.30, 4121.31, 4121.44, 4121.441, 4123.05
Rule Amplifies: 4121.12, 4121.121, 4121.44, 4121.441
Prior Effective Dates: 01/01/1999, 02/16/1999, 02/01/2010
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(A) Upon review by and satisfactory to the bureau that the managed care organization has met bureau certification standards, the bureau shall certify an MCO as eligible to contract with the bureau to provide medical management and cost containment services for injured workers and employers.
(B) MCO certification by the bureau shall be for a period of two years. Upon approval by the bureau, an MCO may expand its coverage area after the first year of certification and every year thereafter.
(C) The bureau may certify any number of MCOs for each county or statewide. Upon approval by the bureau, an MCO may expand its coverage area after the first year of certification and every year thereafter.
(D) The bureau shall maintain a current list of all bureau certified MCOs. The list shall include the name and address of each MCO and the counties in which the MCO is certified.
(E) An MCO may apply to the bureau for recertification beyond the first two years of certification .
Notes
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.121, 4121.30, 4121.31, 4121.44, 4121.441, 4123.05
Rule Amplifies: 4121.12, 4121.121, 4121.44, 4121.441
Prior Effective Dates: 01/01/1999, 02/16/1999, 02/01/2010