Current through P.L. 171-2024
Section 12-15-44.5-5 - Managed care organization responsibilities; reimbursement; cultural competency standards(a) A managed care organization that contracts with the office to provide health coverage, dental coverage, or vision coverage to an individual who participates in the plan: (1) is responsible for the claim processing for the coverage;(2) shall reimburse providers at a rate that is not less than the rate established by the secretary; and(3) may not deny coverage to an eligible individual who has been approved by the office to participate in the plan.(b) A managed care organization that contracts with the office to provide health coverage under the plan must incorporate cultural competency standards established by the office. The standards must include standards for non-English speaking, minority, and disabled populations.Amended by P.L. 201-2023,SEC. 136, eff. 7/1/2023.Amended by P.L. 152-2017,SEC. 34, eff. 7/1/2017.Added by P.L. 213-2015, SEC. 136, eff. 5/7/2015, retroactive.