(1) In order to be eligible to be certified as a MCO, the applicant must submit a preliminary application to the department. The preliminary application must be approved by the department before a final application for certification can be made.

(2) A preliminary application consists of the following elements:

(a) a statement describing the time, place and manner in which services will be provided to claimants (see 24.29.2323) ;

(b) a map showing the areas served by the MCO (see 24.29.2326) ;

(c) information describing the organizational structure of the MCO (see 24.29.2329) ;

(d) the plan for providing managed care (see 24.29.2331) ; and

(e) information concerning the ability of the MCO to meet its financial obligations (see 24.29.2336) .

(3) An applicant must furnish with the preliminary application the name, address and telephone number of a knowledgeable contact person who is familiar with the contents of the preliminary application.

(4) A preliminary application must be accompanied by a non-refundable application fee of $1,500.00. No fee will be required for final applications.

(5) An applicant must furnish an original and three copies of the preliminary application to the department. In lieu of the copies, an applicant may submit the information in an electronic form or on computer readable media that meets the requirements of the department. Applicants should contact the department to determine the format for supplying that information in electronic form or media. The map of the service areas need not be reproduced in electronic form.

(6) Any portion of the preliminary application that the applicant believes in good faith to be a trade secret, protected by the Uniform Trade Secrets Act (Title 30, chapter 14, part 4, MCA) , must be clearly identified as such by the applicant. Any portion of the preliminary application which is not specifically identified as a trade secret is subject to public inspection and disclosure. In the event that a person seeks disclosure of information that is identified as a trade secret, the department will determine whether the individual right to privacy is outweighed by the public right to know, and whether an appropriate protective order can be fashioned to permit disclosure in a way that does not injure the property rights of the applicant.

History: Sec. 39-71-203, 39-71-1103 and 39-71-1105 MCA; IMP, Sec. 39-71-224, 39-71-1103 and 39-71-1105 MCA; NEW, 1994 MAR p. 420, Eff. 3/1/94.