A. A managed care organization or dental benefit manager shall promptly notify the Authority of all changes materially affecting the delivery of care or the administration of its program.
B. A managed care organization or dental benefit manager shall have a medical loss ratio that meets the standards provided by 42 C.F.R., Section 438.8.
C. A managed care organization or dental benefit manager shall provide patient data to a provider upon request to the extent allowed under federal or state laws, rules or regulations including, but not limited to, the Health Insurance Portability and Accountability Act of 1996.
D. A managed care organization or dental benefit manager or a subcontractor of such managed care organization or dental benefit manager shall not enforce a policy or contract term with a provider that requires the provider to contract for all products that are currently offered or that may be offered in the future by the managed care organization or dental benefit manager or subcontractor.
E. Nothing in a contract between the Authority and a managed care organization or dental benefit manager shall prohibit the managed care organization or dental benefit manager from contracting with a statewide or regional accountable care organization to implement the capitated managed care delivery model of the state Medicaid program.
Added by Laws 2021, c. 542, § 5, eff. Sept. 1, 2021.