Ohio Admin. Code 4123-6-03.7 - MCO participation in the HPP - bureau's authority to decertify, to refuse to certify or recertify an MCO
(A) Should the administrator determine that
sufficient evidence exists that an MCO has failed to maintain any of the
requirements set forth in division (F) of section
4121.44 of the Revised Code, or
to reasonably comply with or to perform in accordance with the terms of a
contract between the bureau and the MCO entered into pursuant to division
(B)(4) of section 4121.44 of the Revised Code, or
has violated a rule adopted under section
4121.441 of the Revised Code,
the administrator has the authority to decertify, or refuse to certify or
recertify an MCO, in accordance with rule
4123-6-17
of the Administrative Code and Chapter 119. of the Revised Code.
(B) In any case where the
administrator finds a serious danger to the public health and safety and sets
forth specific reasons for such findings, the administrator may immediately
decertify an MCO.
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: 2/16/96, 1/1/99, 2/1/10, 6/9/14
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(A) Should the administrator determine that sufficient evidence exists that an MCO has failed to maintain any of the requirements set forth in division (F) of section 4121.44 of the Revised Code, or to reasonably comply with or to perform in accordance with the terms of a contract between the bureau and the MCO entered into pursuant to division (B)(4) of section 4121.44 of the Revised Code, or has violated a rule adopted under section 4121.441 of the Revised Code, the administrator has the authority to decertify, or refuse to certify or recertify an MCO , in accordance with rule 4123-6-17 of the Administrative Code and Chapter 119. of the Revised Code.
(B) In any case where the administrator finds a serious danger to the public health and safety and sets forth specific reasons for such findings, the administrator may immediately decertify an
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: 2/16/96, 1/1/99, 2/1/10, 6/9/14