958 CMR, § 3.500

Current through Register 1536, December 6, 2024
Section 3.500 - Disenrollment of Primary Care Provider

Where a carrier allows or requires the designation of a primary care provider, the carrier shall in the event of disenrollment of a primary care provider for reasons other than those related to quality or fraud:

(1) provide to any insured written notice of the disenrollment of the insured's primary care provider at least 30 days prior to any such disenrollment;
(2) include in said notice a description of the procedure for choosing an alternate primary care provider; and
(3) permit the insured to be covered for health services, consistent with the terms of the carrier's evidence of coverage, provided by such primary care provider for at least 30 days after the provider is disenrolled.

958 CMR, § 3.500

Amended by Mass Register Issue 1494, eff. 4/28/2023.