North Carolina General Statutes 58-67-11. Additional HMO application information
(a) In addition to the information filed under N.C. Gen. Stat. § 58-67-10(c), each application shall include a description of the following:
(1) The program to be used to evaluate whether the applicant’s provider network is sufficient, in numbers and types of providers, to assure that all health care services will be accessible without unreasonable delay.
(2) The program to be used for verifying provider credentials.
(3) The quality management program to assure quality of care and health care services managed and provided through the health care plan.
(4) The utilization review program for the review and control of health care services provided or paid for.
(5) The applicant’s provider network and evidence of the ability of that network to provide all health care services to the applicant’s prospective enrollees.
(b) N.C. Gen. Stat. § 58-67-10(d) applies to the information specified in this section. (1997-519, s. 1.2.)
Terms Used In North Carolina General Statutes 58-67-11
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- following: when used by way of reference to any section of a statute, shall be construed to mean the section next preceding or next following that in which such reference is made; unless when some other section is expressly designated in such reference. See North Carolina General Statutes 12-3