Lawriter - OAC - 4123-6-03.4 MCO participation in the HPP - MCO certification.

4123-6-03.4 MCO participation in the HPP - MCO certification.

(A) Upon review by and satisfactory to the bureau that the managed care organization has met bureau certification standards, the bureau shall certify an MCO as eligible to contract with the bureau to provide medical management and cost containment services for injured workers and employers.

(B) MCO certification by the bureau shall be for a period of two years. Upon approval by the bureau, an MCO may expand its coverage area after the first year of certification and every year thereafter.

(C) The bureau may certify any number of MCOs for each county or statewide.

(D) The bureau shall maintain a current list of all bureau certified MCOs. The list shall include the name and address of each MCO and the counties in which the MCO is certified.

(E) An MCO may apply to the bureau for recertification beyond the first two years of certification.

Five Year Review (FYR) Dates: 08/26/2015 and 08/25/2020
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.121, 4121.30, 4121.31, 4121.44, 4121.441, 4123.05
Rule Amplifies: 4121.12, 4121.121, 4121.44, 4121.441
Prior Effective Dates: 2/16/99, 1/1/99, 2/1/10

Prior History: (Effective: 02/01/2010
119.032 review dates: 11/17/2009 and 2/21/15
Promulgated Under: 119.03
Statutory Authority: RC 4121.12, 4121.121, 4121.30, 4121.31, 4123.05
Rule Amplifies: RC 4121.121, 4121.44, 4121.441, 4123.66
Prior Effective Dates: 2/16/99, 1/1/99)