Md. Code Regs. 10.67.12.01 - General
A. An MCO shall
establish a corrective managed care plan that, at minimum, provides for:
(1) The identification of an enrollee that
has abused MCO pharmacy benefits; and
(2) The enrollment of an enrollee that has
been determined to have abused MCO pharmacy benefits in the MCO's corrective
managed care plan.
B.
Enrollee abuse exists when an enrollee:
(1)
Has engaged in behaviors identified in COMAR 10.67.24.14-1; or
(2) Engages in Medicaid fraud as defined
under COMAR 10.67.24.14.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.