Rule Chapter: 37.108
	Chapter Title: MANAGED CARE QUALITY ASSURANCE

PUBLIC HEALTH AND HUMAN SERVICES		View as eBook	Add to Favorites
	37.108 : MANAGED CARE QUALITY ASSURANCE

Click on the Rule No. to see Rule text.

Press Ctrl-F to search by text.

Rule No. Rule Title Latest Version Effective Date Subchapter 1 reserved Subchapter 2 Network Adequacy for Managed Care 37.108.201 DEFINITIONS TRANS 10/21/2023 Rules 37.108.202 through 37.108.204 reserved 37.108.205 ACCESS PLAN FILING AND REVIEW GUIDELINES TRANS 10/21/2023 37.108.206 ACCESS PLAN UPDATES TRANS 10/21/2023 37.108.207 ACCESS PLAN SPECIFICATIONS TRANS 10/21/2023 37.108.208 ACCESS CRITERIA TRANS 10/21/2023 Rules 37.108.209 through 37.108.213 reserved 37.108.214 MANDATORY COVERAGE TRANS 10/21/2023 37.108.215 PROVIDER-ENROLLEE RATIO REQUIREMENTS TRANS 10/21/2023 37.108.216 VERIFICATION OF PROVIDER CREDENTIALS TRANS 10/21/2023 Rules 37.108.217 and 37.108.218 reserved 37.108.219 GEOGRAPHIC ACCESS CRITERIA TRANS 10/21/2023 37.108.220 EXCEPTIONS TO GEOGRAPHIC ACCESS CRITERIA TRANS 10/21/2023 37.108.221 SERVICE AREAS TRANS 10/21/2023 Rules 37.108.222 through 37.108.226 reserved 37.108.227 MAXIMUM WAIT TIMES FOR APPOINTMENTS TRANS 10/21/2023 37.108.228 REFERRAL AND SPECIALTY CARE REQUIREMENTS TRANS 10/21/2023 37.108.229 CONTINUITY OF CARE AND TRANSITIONAL CARE TRANS 10/21/2023 Rules 37.108.230 through 37.108.234 reserved 37.108.235 SELECTING AND CHANGING PROVIDERS TRANS 10/21/2023 37.108.236 REMOVAL OF BARRIERS TO ACCESS TRANS 10/21/2023 Rules 37.108.237 through 37.108.239 reserved 37.108.240 MONITORING THE NETWORK TRANS 10/21/2023 37.108.241 LETTERS OF INTENT TRANS 10/21/2023 37.108.242 RESPONSIBILITY FOR CONTRACTED SERVICES TRANS 10/21/2023 Rules 37.108.243 through 37.108.249 reserved 37.108.250 CORRECTIVE ACTION TRANS 10/21/2023 37.108.251 APPEAL FROM DEPARTMENT DECISION TRANS 10/21/2023 Subchapter 3 Independent Review of Health Care Decisions 37.108.301 INDEPENDENT REVIEW OF HEALTH CARE DECISIONS: DEFINITIONS 8/1/2003 Rules 37.108.302 through 37.108.304 reserved 37.108.305 INDEPENDENT REVIEW OF HEALTH CARE DECISIONS: PEER REVIEW PROCESS 8/1/2003 37.108.306 INDEPENDENT REVIEW OF HEALTH CARE DECISIONS: CONFIDENTIALITY 12/17/1999 Rules 37.108.307 through 37.108.309 reserved 37.108.310 INDEPENDENT REVIEW OF HEALTH CARE DECISIONS: NOTICE OF ADVERSE DETERMINATION AND INDEPENDENT REVIEW RIGHTS 8/1/2003 Rules 37.108.311 through 37.108.314 reserved 37.108.315 INDEPENDENT REVIEW OF HEALTH CARE DECISIONS: INTERNAL APPEALS PROCESS 8/1/2003 Subchapter 5 Quality Assurance for Managed Care Plans 37.108.501 PURPOSE TRANS 1/1/2024 37.108.502 DEFINITIONS TRANS 1/1/2024 Rules 37.108.503 and 37.108.504 reserved 37.108.505 QUALITY ASSURANCE STRUCTURE AND ACCREDITATION TRANS 1/1/2024 37.108.506 WRITTEN DESCRIPTION OF QUALITY ASSESSMENT PLAN TRANS 1/1/2024 37.108.507 COMPONENTS OF QUALITY ASSESSMENT ACTIVITIES TRANS 1/1/2024 Rules 37.108.508 and 37.108.509 reserved 37.108.510 QUALITY IMPROVEMENT TRANS 1/1/2024 37.108.511 CLINICAL FOCUSED STUDY TRANS 1/1/2024 Rules 37.108.512 through 37.108.514 reserved 37.108.515 ENROLLEE COMPLAINT SYSTEM TRANS 1/1/2024 37.108.516 RECORDING CONSUMER SATISFACTION TRANS 1/1/2024 Rules 37.108.517 through 37.108.519 reserved 37.108.520 CORRECTIVE ACTION TRANS 1/1/2024 37.108.521 INFORMAL RECONSIDERATION OF DEPARTMENT DECISION TRANS 1/1/2024