N.M. Admin. Code § 13.10.7.13

Current through Register Vol. 35, No. 24, December 23, 2024

Section 13.10.7.13 - ADMINISTRATIVE AND MANAGERIAL ARRANGEMENTS

Each HMO shall have administrative and managerial arrangements satisfactory to the superintendent as demonstrated by at least the following:

A. a policy-making body which exercises oversight and control over the HMO's policies and personnel to assure that management actions are in the best interests of the HMO and its enrollees; and

B. personnel and systems sufficient for the HMO to organize, plan, control and evaluate the financial, marketing, health services, quality assurance program, administrative and management aspects of HMO. At a minimum, the HMO shall be managed by an executive whose appointment and removal are under the control of the HMO's policy-making body.

N.M. Admin. Code § 13.10.7.13

6/1/98; Recompiled 11/30/01