§ 301.312. Initial contract filing.
(a) An HMO shall file with the Department any contract entered into with an IDS under which the IDS will assume risk and perform other functions as indicated in section 8(b) of the act (40 P. S. § 1558(b)).
(b) Under this authority, the Commissioner will require that when an HMO initially enters into a contract with an IDS, the HMO shall file the contract with the Department not later than the filing of the next quarterly or annual financial statement, whichever occurs first, following the effective date of the contract, together with a written report in a form which will be available from the Department.
(c) If no quarterly financial statement is required by the Department, the Department requests that contracts with an IDS, together with a written report, be filed within 45 days of the effective date of the contract.
(d) Initial contract filings may be submitted with any additional information that may be appropriate for the Department’s review, such as a cover letter describing the following:
(1) The extent to which functions are transferred to the IDS and the extent and type of services which will be provided by the IDS.
(2) The relationship between the IDS and the participating providers, and the manner in which services will be delivered by participating providers.
(3) The identities of IDS subcontractors.
(4) The reimbursement methodology, and a copy of security arrangements relating thereto, between the HMO and IDS.
Cross References This section is cited in 31 Pa. Code § 301.313 (relating to filings upon contract changes).
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