5101:6-2-36 Notice of denial of just cause request for termination of managed care plan membership.

(A) Following the bureau of managed health care's determination that the request does not meet one of the criteria for just cause termination of managed care plan membership, the ODJFS bureau of managed health care must send a notice to an individual.

(B) The notice must contain a clear and understandable statement that the request was denied, explain the response why the request for just cause termination of managed care plan membership did not meet the criteria for just cause termination of managed care plan membership, cite the applicable regulations, explain the individual's right to and the method of obtaining a state hearing and contain a telephone number to call about free legal services.

(C) "Notice of Denial of Just Cause Request for Termination of Managed Care Plan Membership," JFS 01711 (rev. 8/2003), must be used.

Effective: 09/01/2008
R.C. 119.032 review dates: 05/30/2008 and 09/01/2013
Promulgated Under: 119.03
Statutory Authority: 5101.35
Rule Amplifies: 5101.35
Prior Effective Dates: 5/31/04