Title: Section 360-10.2 - Scope

Section 360-10.2 Scope.

This Subpart describes:

(a) individuals required to enroll in an MMCO;

(b) individuals exempt or excluded from enrollment in an MMCO;

(c) good cause reasons for permitting an enrollee to change or disenroll from an MMCO;

(d) good cause reasons for permitting an enrollee to change primary care providers (PCPs);

(e) the fair hearing rights for managed care enrollees;

(f) marketing/outreach requirements for MMCOs;

(g) MMCO unacceptable practices;

(h) MMCO sanctions and due process.