31 Pa. Code § 154.1 - Applicability and purpose
(a)
This chapter governs quality health care accountability and protection and
applies to managed care plans and licensed insurers subject to the act. The
Department and the Department of Health both have regulatory authority under
the act. This chapter does not apply to health care services and claims
processed under automobile and worker's compensation policies.
(b) The terms and conditions of group and
individual contract renewals and new business written by managed care plans on
or after January 1, 1999, shall conform to the act.
(c) An entity, including an IDS,
subcontracting with a managed care plan to provide services to enrollees shall
meet the requirements of the act and this chapter for services provided to
those enrollees.
(d) Policies which
partially insure an entity's risk, shall meet the requirements of the act if
they are issued by a managed care plan.
Notes
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