440 Ind. Admin. Code 4.3-2-6

Current through January 8, 2025

Section 440 IAC 4.3-2-6 - Recertification

Authority: IC 12-21-2-3; IC 12-21-2-8; IC 12-21-5-1.5

Affected: IC 12-7-2-40.6

Sec. 6.

(a) A managed care provider shall apply for recertification every three (3) years.

(b) To be recertified as a managed care provider, the provider shall file an application according to the schedule determined by the division and on a form prepared by the division.

(c) The application shall include the same information as is required at section 4(c) of this rule.

(d) The division may require the applicant to resolve any problems identified by the accrediting agency within the time period contained in the notification from the division.

(e) The division shall examine the performance of the managed care provider in meeting the requirements of the division's quality assurance program.

(f) The division shall consider whether the entity has met the requirements of the managed care provider contract.

(g) The entity is eligible to contract with the division as a managed care provider when:

(1) an application for recertification is deemed to meet the requirements in this rule;

(2) the division has determined that the managed care provider has met the requirements of the division's quality assurance program; and

(3) the managed care provider has taken any action required by the division, including action in response to the survey recommendations of the accrediting agency.

(h) When the division issues a contract, a document certifying the entity as a managed care provider with a regular certification shall be issued by the division.

(i) If an entity fails to apply for certification, or applies for certification and it is denied, the agency may not reapply until the next scheduled application period.

440 IAC 4.3-2-6

Division of Mental Health and Addiction; 440 IAC 4.3-2-6; filed Oct 11, 1996, 2:00 p.m.: 20 IR 756; filed Mar 13, 2000, 7:44 a.m.: 23 IR 1989; readopted filed May 10, 2001, 2:30 p.m.: 24 IR 3235; readopted filed Apr 7, 2008, 3:40 p.m.: 20080507-IR-440070745RFA; Readopted filed 8/11/2014, 11:21 a.m.: 20140910-IR-440140240RFA

Readopted filed 11/9/2020, 3:09 p.m.: 20201209-IR-440200502RFA