Section 405 IAC 14-6-10 - Second opinionsAuthority: IC 12-15-1-10
Affected: IC 12-15-5; IC 12-15-12
Sec. 10.
(a) Under federal requirements at 42 CFR 438.206(b)(3), an MCO shall comply with any member request for a second opinion from a qualified professional.(b) If the MCO's contracted provider network does not include a provider qualified to give a second opinion as requested by a member, the MCO shall arrange for the member to obtain a second opinion from a provider outside the MCO's network, at no cost to the member.Office of the Secretary of Family and Social Services; 405 IAC 14-6-10; filed 8/30/2024, 11:42 a.m.: 20240925-IR-405240180FRA