(A) Should the administrator determine that sufficient evidence exists that an MCO has failed to comply with applicable workers' compensation statutes, rules governing MCOs, or a provision of a contract between the bureau and the MCO or for any other reason as set forth in rule 4123-6-03.6 of the Administrative Code, the administrator has the authority to decertify, or refuse to certify or recertify an MCO.
(B) In any case where the administrator finds a serious danger to the public health and safety and sets forth specific reasons for such findings, the administrator may immediately decertify an MCO.
(C) Upon a final order of the administrator to decertify, or refuse to recertify an MCO, employees and employers shall not receive services from such MCO pursuant to the HPP.
(D) Upon a final order of the administrator to decertify or refuse to recertify an MCO, any obligation of a provider to provide services under the HPP pursuant to a contract or agreement with such MCO shall be null and void.
R.C. 119.032 review dates: 11/17/2009 and 02/01/2015
Promulgated Under: 119.03
Statutory Authority: 4121.12 , 4121.121 , 4121.30 , 4121.31 , 4123.05
Rule Amplifies: 4121.121 , 4121.44 , 4121.441 , 4123.66
Prior Effective Dates: 2/16/95, 1/1/99