24.29.2361 APPLICATION TO RENEW CERTIFICATION, NOTICE OF INTENT NOT TO RENEW CERTIFICATION
(1) At least 60 days, but not more than 120 days, before the MCO certification expires, a MCO must either apply to renew the certification or provide written notice to the department and any insurer with which it has a contract that the MCO will not be renewing its certification.
(2) In order to be eligible to renew its certification, the MCO must be current with all reports and information required to be filed with the department.
(3) Each approved MCO, in order to renew certification, must submit an application for renewal containing the following information:
(a) a signed statement from the day-to-day administrator of the MCO certifying that the MCO is not formed, owned or operated by a workers' compensation insurer or self-insured employer, other than a health care provider;
(b) the name, title, address and telephone number of the person who will act as the liaison between the department and the MCO;
(c) the name, title, address and telephone number of the person who is the day-to-day administrator of the MCO;
(d) the name, address and medical specialty, of the medical director, if any, of the MCO;
(e) a list of the current members, including names, specialty, addresses, and telephone numbers, together with a signed statement from the medical director or day-to-day administrator of the MCO certifying that each individual on the list is properly licensed to perform those services;
(f) a list of the insurers with which the MCO has contracts and the expiration dates of the contracts; and
(g) a summary of any sanctions or punitive actions taken by the MCO against members.