4123-6-05.4 Employer access to the HPP; payment for group rating referrals prohibited.

(A) An MCO shall not solicit, receive, or accept any payment, commission, consideration, money, or other thing of value, including, but not limited to any rebate, premium, or kickback, as an inducement to or in return for the MCO’s referral of employers who have selected or been assigned to it to any sponsoring organization or group for the purpose of participating in a group experience rating program authorized under section 4123.29 of the Revised Code and rules 4123-17-61 to 4123-17-68 of the Administrative Code.

(B) An MCO that violates this rule may be subject to decertification or termination of its contract pursuant to the rules of this chapter of the Administrative Code.

R.C. 119.032 review dates: 10/27/2004 and 03/01/2009

Promulgated Under: 119.03

Statutory Authority: 4121.12, 4121.30, 4121.31, 4123.05

Rule Amplifies: 4121.121, 4121.44, 4121.441, 4123.66

Prior Effective Dates: 1/30/98 (Emer.), 4/29/98, 1/1/99, 1/1/01