28 Tex. Admin. Code § 11.2609 - Reserve Requirements for Delegated Networks

In addition to any other requirements set forth in this subchapter, an HMO that contracts with a delegated network must ensure that the delegated network complies with Insurance Code Chapter 1272, Subchapter D, (concerning Reserve Requirements). The HMO's agreement with the delegated network must include a provision:

(1) that records related to the requirements of Insurance Code Chapter 1272, Subchapter D, must be accessible at all times to the HMO;

(2) requiring all financial records and related information necessary to show the delegated network's compliance with the requirements of Insurance Code Chapter 1272, Subchapter D;

(3) making the records described in paragraph (1) of this section available to the department on request; and

(4) that records be kept providing evidence that the HMO has adequately monitored the delegated network for compliance with the requirements of Insurance Code Chapter 1272, Subchapter D.

Notes

28 Tex. Admin. Code § 11.2609

The provisions of this §11.2609 adopted to be effective October 13, 2002, 27 TexReg 9585; amended to be effective November 15, 2006, 31 TexReg 9298; Adopted by Texas Register, Volume 42, Number 16, April 21, 2017, TexReg 2266, eff. 8/1/2017