Chapter 5160-26 - Managed Care Plan

  1. § 5160-26-01 - Managed: definitions
  2. § 5160-26-02 - Managed: eligibility and enrollment
  3. § 5160-26-02.1 - Managed care: termination of enrollment
  4. § 5160-26-03 - Managed care: covered services
  5. § 5160-26-03.1 - Managed care: primary care and utilization management
  6. § 5160-26-03.2 - Managed care: long-term services and supports respite services for children
  7. § 5160-26-04 - [Rescinded] Managed health care programs: procurement and plan selection
  8. § 5160-26-05 - Managed care: provider network and contracting requirements
  9. § 5160-26-05.1 - Managed care: provider services
  10. § 5160-26-06 - Managed care: program integrity - fraud, waste and abuse, audits, reporting, and record retention
  11. § 5160-26-07 - [Rescinded] Managed health care programs: annual external quality review survey
  12. § 5160-26-07.1 - [Rescinded] Managed health care programs: Quality assessment and performance improvement program (QAPI)
  13. § 5160-26-08 - [Rescinded] Managed health care programs: marketing
  14. § 5160-26-08.1 - [Rescinded] Managed health care programs: information and enrollment services
  15. § 5160-26-08.2 - [Rescinded] Managed health care programs: member services
  16. § 5160-26-08.3 - Managed care: member rights
  17. § 5160-26-08.4 - Managed care: appeal and grievance system
  18. § 5160-26-08.5 - [Rescinded] Managed health care programs: responsibilities for state hearings
  19. § 5160-26-09 - [Rescinded] Managed health care programs: payment and financial responsibility
  20. § 5160-26-09.1 - Managed care: third party liability and recovery
  21. § 5160-26-10 - Managed care: sanctions and provider agreement actions
  22. § 5160-26-11 - Managed care: non-contracting providers
  23. § 5160-26-12 - Managed care: member co-payments
  24. § 5160-26-13 - Managed health care programs: claim billing for pharmaceuticals

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.