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  • 317:55-3-1.  Mandatory populations
  • 317:55-3-2.  Excluded populations
  • 317:55-3-3.  Voluntary enrollment and disenrollment
  • 317:55-3-10. Grievances and appeals
  • 317:55-3-11. Intermediate sanctions
  • 317:55-3-12. Non-compliance damages and remedies
  • 317:55-3-13. Termination of managed care contract
  • 317:55-3-14. Record retention
  • 317:55-3-20. Authorizations
  • 317:55-3-21. Timing

  • 317:55-5-1. MCO or DBM accreditation
  • 317:55-5-2. MCO or DBM readiness
  • 317:55-5-10. Provider contracts and credentialing standards
  • 317:55-5-11. Network adequacy standards
  • 317:55-5-12. Prior authorization requirements, generally
  • 317:55-5-13. Notification of material change
  • 317:55-5-14. Patient data
  • 317:55-5-20. Capitation rates
  • 317:55-5-21. Medical loss ratio
  • 317:55-5-22. Value-based purchasing
  • 317:55-5-23. Special contract provisions related to payment
  • 317:55-5-24. Hospital readmission damages
  • 317:55-5-25. Claims processing and methodology; post payment audits
  • 317:55-5-30. Managed care quality advisory committee
  • 317:55-5-31. Quality scorecard
  • 317:55-5-40. Accountable care organization, no prohibition
  • 317:55-5-41. Accountable care organization, duties

 

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