Chapter 17F - NETWORK ADEQUACY STANDARDS

Section 58-17F-1 - Definitions
Section 58-17F-2 - Health benefit plan defined
Section 58-17F-3 - Medical director required for managed care plans
Section 58-17F-4 - Health carrier to provide written information to prospective enrollees-Specific information required
Section 58-17F-5 - Health carrier to maintain provider network sufficient to assure services without unreasonable delay-Emergency services-Determination of sufficiency
Section 58-17F-6 - Where provider network is insufficient, covered benefit to be made available at no greater cost
Section 58-17F-7 - Health carrier to ensure provider proximity to covered persons
Section 58-17F-8 - Health carrier to monitor provider ability, capacity, and authority-Financial capability to be monitored in capitated plans
Section 58-17F-9 - Factors to consider in determining network adequacy
Section 58-17F-10 - Access plan required for managed care plans-Annual update-Contents-Exemptions for discounted fee-for-service networks
Section 58-17F-11 - Requirements for health carrier and providers in managed care plans
Section 58-17F-12 - Provisions governing contractual arrangements between health carriers and intermediaries
Section 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
Section 58-17F-14 - Contract does not relieve health carrier of liability
Section 58-17F-15 - Remedies available to director against health carrier found not in compliance
Section 58-17F-16 - Managed care contractor to register with director
Section 58-17F-17 - Filing changes in registration information
Section 58-17F-18 - Request for information from managed care contractor
Section 58-17F-19 - Activities of nonregistered managed care contractor prohibited
Section 58-17F-20 - Registration fee for managed care contractor
Section 58-17F-21 - Promulgation of rules