Chapter 408. Certificate of Quality Assurance of Managed Care Health Insurance Planlicensees  


Section 10. Definitions
Section 20. Responsibility of the department
Section 30. Certificate of quality assurance
Section 40. Fees
Section 50. Compliance provisions appropriate for type of plan
Section 60. General examination process
Section 70. Administrative review
Section 80. Renewal application
Section 90. Comprehensive onsite examination
Section 100. Examination by a nationally recognized accreditation organization
Section 110. Corrective action procedures
Section 120. Changes to geographic service areas
Section 130. Complaint system, complaint examination and investigation
Section 140. Administrative sanctions
Section 150. Surrender of certificate
Section 160. Management and administration
Section 170. Provider credentialing and recredentialing
Section 180. Complaint system
Section 190. Covered person education and communication
Section 200. Data management
Section 210. Medical records
Section 220. Purpose
Section 230. Program requirements
Section 240. Quality assurance plan
Section 250. Continuity of care
Section 260. Network adequacy
Section 270. Travel and appointment waiting times
Section 280. Urgent care and emergency services
Section 290. Health promotion
Section 300. Clinical performance evaluation systems
Section 310. Data collection and submission
Section 320. Delegated services
Section 330. Written agreement
Section 340. Exchange of information
Section 350. Quality assurance program
Section 360. Utilization review and management
Appendix 9998. FORMS (12VAC5-408)
Appendix 9999. DOCUMENTS INCORPORATED BY REFERENCE (12VAC5-408)