Section 360-10.2 - Scope
Effective Date
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.