BEFORE THE COMMISSIONER OF SECURITIES AND INSURANCE

OFFICE OF THE MONTANA STATE AUDITOR

 

In the matter of the transfer of ARM Title 37, chapter 108, subchapter 2 pertaining to Network Adequacy for Managed Care Plans

) ) ) )

NOTICE OF TRANSFER

TO: All Concerned Persons

 

            1. The Department of Public Health and Human Services (DPHHS) transfers the above-stated rules to the Commissioner of Securities and Insurance, Office of the Montana State Auditor (CSI), in ARM Title 6, chapter 6, subchapter 88.

 

            2. This transfer is required because House Bill 156, Sections 38 through 53, 68th Legislature (2023), transferred from DPHHS to the CSI the administrative function and responsibilities related to ensuring compliance with standards for network adequacy for managed care.

 

3.  The transferred rules are assigned the following numbers under the CSI:

 

OLD                            NEW

37.108.201                6.6.8801                     DEFINITIONS

37.108.205                6.6.8805                     ACCESS PLAN FILING AND REVIEW

                                                                                    GUIDELINES

37.108.206                6.6.8806                     ACCESS PLAN UPDATES

37.108.207                6.6.8807                     ACCESS PLAN SPECIFICATIONS        

37.108.208                6.6.8808                     ACCESS CRITERIA

37.108.214                6.6.8814                     MANDATORY COVERAGE

37.108.215                6.6.8815                     PROVIDER-ENROLLEE RATIO

                                                                                    REQUIREMENTS

37.108.216                6.6.8816                     VERIFICATION OF PROVIDER

                                                                                    CREDENTIALS

37.108.219                6.6.8819                     GEOGRAPHIC ACCESS CRITERIA

37.108.220                6.6.8820                     EXCEPTIONS TO GEOGRAPHIC

                                                                                    ACCESS CRITERIA

37.108.221                6.6.8821                     SERVICE AREAS

37.108.227                6.6.8827                     MAXIMUM WAIT TIMES FOR

                                                                                     APPOINTMENTS

37.108.228                6.6.8828                     REFERRAL AND SPECIALTY CARE

                                                                                    REQUIREMENTS

37.108.229                6.6.8829                     CONTINUITY OF CARE AND

                                                                                    TRANSITIONAL CARE

37.108.235                6.6.8835                     SELECTING AND CHANGING

                                                                                    PROVIDERS

37.108.236                6.6.8836                     REMOVAL OF BARRIERS TO ACCESS

37.108.240                6.6.8840                     MONITORING THE NETWORK

37.108.241                6.6.8841                     LETTERS OF INTENT

37.108.242                6.6.8842                     RESPONSIBILITY FOR CONTRACTED

                                                                                    SERVICES

37.108.250                6.6.8850                     CORRECTIVE ACTION

37.108.251                6.6.8851                     APPEAL FROM DEPARTMENT DECISION

 

 

/s/ Ole Olson                                                 /s/ Mary Belcher                  

Ole Olson                                                      Mary Belcher

Rule Reviewer                                              Deputy Auditor

                                                                        Commissioner of Securities and Insurance,

                                                                        Office of the Montana State Auditor

 

 

Certified to the Secretary of State October 10, 2023.