TITLE 33. INSURANCE AND INSURANCE COMPANIES

CHAPTER 36. MANAGED CARE PLAN NETWORK ADEQUACY AND QUALITY ASSURANCE

Part 1. General Provisions

Department -- General Powers And Duties -- Rulemaking

33-36-105. Department -- general powers and duties -- rulemaking. (1) The department shall:

(a) adopt rules pursuant to the Montana Administrative Procedure Act establishing minimum state standards for network adequacy and quality assurance and procedures for ensuring compliance with those standards; and

(b) recommend action to the commissioner against a health carrier whose managed care plan does not comply with standards for network adequacy and quality assurance adopted by the department.

(2) Quality assurance standards adopted by the department must consist of some but not all of the health plan employer data and information standards. The department shall select and adopt only standards appropriate for quality assurance in Montana.

(3) The state may contract, through a competitive bidding process, for the development of network adequacy and quality assurance standards.

History: En. Sec. 12, Ch. 413, L. 1997.