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PA Bulletin, Doc. No. 04-2038

NOTICES

Technical Advisory for Managed Care Plans Seeking to Offer Benefit Plans With Less Than 80% Plan Paid Co-Insurance for Out-of-Network Covered Services

[34 Pa.B. 6205]

   Under 28 Pa. Code § 9.603 (relating to technical advisories), the Department of Health (Department), Bureau of Managed Care is issuing notice of the availability of a technical advisory on Department review of a managed care plan seeking to offer benefit plans with less than 80% plan paid co-insurance for out-of-network covered services. See 31 P. S. § 152.4 (relating to scope of Department of Health review of a preferred provider organization). Nothing in the advisory abrogates the requirements imposed by section 4 of the Individual Accident and Sickness Insurance Minimum Standards Act (40 P. S. § 776.4) and the regulations applicable to that section.

   Copies of the technical advisory may be obtained by contacting William Wiegmann, Director, Division of Certification, Department of Health, Room 912, Health and Welfare Building, P. O. Box 90, Harrisburg, PA 17108-0090, (717) 787-5193 or for speech and/or hearing impaired persons, V/TT: (717) 783-6154 or the Pennsylvania AT&T Relay Service at (800) 654-5984 [TT]. The technical advisory will also appear on the Department's website at www.health.pa.state.us.

   Persons with a disability who require alternative format of this notice (for example, large print, audiotape, Braille) should contact William Wiegmann at the previously mentioned address or telephone numbers.

CALVIN B. JONHSON, M.D., M.P.H.,   
Secretary

[Pa.B. Doc. No. 04-2038. Filed for public inspection November 12, 2004, 9:00 a.m.]


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