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UNOFFICIAL 1735.2-2 §17-1735.2-1 Purpose. This chapter describes the requirements for the participation of health plans under the medical assistance program. [Eff 09/30/13] (Auth: HRS §346-14) (Imp: HRS §346- 14; 42 C.F.R. §430.25)
§17-1735.2-2 Health plan participation in the medical assistance program. (a) The department shall request proposals from managed care health plans for provision of healthcare services to an eligible individual to participate in the medical assistance program. (b) The department shall evaluate the proposals from managed care plans to ensure that the plans meet the conditions and requirements described in the department's request for proposals. (c) Contracts for participation in the medical assistance program shall be awarded to qualified health plans upon finalization of financial agreements with the department. (d) The department shall develop a request for proposals prior to the lapse of existing contracts with participating health plans to ensure that beneficiaries receive continued health care coverage. [Eff 09/30/13] (Auth: HRS §346-14) (Imp: HRS §346- 14; 42 C.F.R. §430.25)
§17-1735.2-3 Service areas. (a) The department shall designate geographic areas as the areas for which health plans will submit proposals to provide services. (b) A health plan may submit proposals to service more than one service area. (c) More than one health plan may be contracted by the department for each service area. [Eff 09/30/13] (Auth: HRS §346-14) (Imp: HRS §346- 14; 42 C.F.R. §430.25)