Rule 120-2-80-.03 - Application(1) Managed care entities may make application for a managed care plan or plans to be certified under this Regulation Chapter by submitting Form GID PPA-1 with a filing fee of $500.00.(2) The Commissioner shall have ninety (90) days after receipt of the application in which to review the application. During this period the Commissioner may request additional information as necessary. The Commissioner may extend the time in which to review an application by contacting the applicant in writing and he or she is not required to act on an incomplete application.(3) Managed care entities with previously approved managed care plans in use in this state as of the effective date of this Regulation Chapter must submit applications for certification no later than ninety (90) days after the effective date of this Regulation Chapter. Managed care entities making timely filing of an application for certification of previously approved managed care plans may continue to offer such plans until the Commissioner determines such plans do not comply with the requirements of the Patient Protection Act or this Regulation Chapter.(4) Managed care entities making application for certification of managed care plans which are not yet approved may not offer such managed care plans until the application for certification under this Regulation Chapter is approved and the managed care product is approved in accordance with other requirements under O.C.G.A. § 33-24-9 as well as any other applicable laws and Regulation Chapters. This requirement for prior certification shall apply to all managed care plans not offered by the effective date of this Regulation Chapter.(5) Within the discretion of the Commissioner, managed care entities which have attained accreditation or which use managed care contractors accredited by national boards, committees or other accepted industry standard setting organizations may satisfy some or all of the requirements for certification.Ga. Comp. R. & Regs. R. 120-2-80-.03
O.C.G.A. Secs. 33-2-9, 33-20A-2, 33-20A-4, 33-20A-5.
Original Rule entitled "Applications" adopted. F. Mar. 20, 1998; eff. Apr. 9, 1998 .