Current through Register Vol. 49, No. 8, August 19, 2024
Section 62Q.746 - ACCESS TO CERTAIN INFORMATION REGARDING PROVIDERSUpon request of the commissioner, a health plan company licensed under chapters 62C and 62D must provide the following information:
(1) a detailed description of the health plan company's methods and procedures, standards, qualifications, criteria, and credentialing requirements for designating the providers who are eligible to participate in the health plan company's provider network, including any limitations on the numbers of providers to be included in the network;(2) the number of full-time equivalent physicians, by specialty, nonphysician providers, and allied health providers used to provide services; and(3) summary data that is broken down by type of provider, reflecting actual utilization of network and non-network practitioners and allied professionals by enrollees of the health plan company.