28 Tex. Admin. Code § 11.502

Current through Reg. 49, No. 24; June 14, 2024
Section 11.502 - Filing Requirements for Evidence of Coverage Filed as Part of an Application for a Certificate of Authority
(a) The filing and formatting requirements of § 11.301(1)(B) and (2)(A) of this title (relating to Filing Requirements) apply to an evidence of coverage, when filed as part of the application for a certificate of authority.
(b) During the review period, an applicant must submit each new page or form reflecting any revisions.
(c) No later than the 10th calendar day after approval or issuance of a certificate of authority, an HMO must file a clean, final version of the evidence of coverage with revisions and a copy of the original version of the evidence of coverage showing the new or revised text as redlined. The submission must include:
(1) an explanation that the evidence of coverage was submitted as part of the application for a certificate of authority and is being submitted in compliance with this subsection;
(2) a certification that the forms are without deviation and are the exact final evidence of coverage versions that resulted in approval of the certificate of authority application; and
(3) the final version of an approved service area description and map as attached to the evidence of coverage, with key and scale, which must identify the county or counties or portions of counties to be served.
(d) Any discrepancy in content between the final document to be issued and the approved version is grounds for revocation of a certificate of authority.

28 Tex. Admin. Code § 11.502

The provisions of this §11.502 adopted to be effective January 1, 1980, 4 TexReg 4622; amended to be effective December 4, 1987, 12 TexReg 4363; amended to be effective August 17, 1992, 17 TexReg 5356; amended to be effective November 2, 1998, 23 TexReg 11347; amended to be effective February 24, 2005, 30 TexReg 854; Adopted by Texas Register, Volume 42, Number 16, April 21, 2017, TexReg 2232, eff. 8/1/2017