CHAPTER 58-17F

NETWORK ADEQUACY STANDARDS

58-17F-1    Definitions.

58-17F-2    Health benefit plan defined.

58-17F-3    Medical director required for managed care plans.

58-17F-4    Health carrier to provide written information to prospective enrollees--Specific information required.

58-17F-5    Health carrier to maintain provider network sufficient to assure services without unreasonable delay--Emergency services--Determination of sufficiency.

58-17F-6    Where provider network is insufficient, covered benefit to be made available at no greater cost.

58-17F-7    Health carrier to ensure provider proximity to covered persons.

58-17F-8    Health carrier to monitor provider ability, capacity, and authority--Financial capability to be monitored in capitated plans.

58-17F-9    Factors to consider in determining network adequacy.

58-17F-10    Access plan required for managed care plans--Annual update--Contents--Exemptions for discounted fee-for-service networks.

58-17F-11    Requirements for health carrier and providers in managed care plans.

58-17F-12    Provisions governing contractual arrangements between health carriers and intermediaries.

58-17F-13    Sample contract forms to be filed with director--Material changes to be submitted--Certain changes not material--Director's inaction within certain time deemed approval--Contract copies to be provided upon request.

58-17F-14    Contract does not relieve health carrier of liability.

58-17F-15    Remedies available to director against health carrier found not in compliance.

58-17F-16    Managed care contractor to register with director.

58-17F-17    Filing changes in registration information.

58-17F-18    Request for information from managed care contractor.

58-17F-19    Activities of nonregistered managed care contractor prohibited.

58-17F-20    Registration fee for managed care contractor.

58-17F-21    Promulgation of rules.