Appendix 01 |
HMO Act (40 P.S. 1551-1568) |
Appendix 02 |
Department of Health HMO Regulations |
Appendix 03 |
Insurance Department HMO Regulations |
Appendix 04 |
Insurance Department Accident and Health Filing Reform Act (40 P.S. 3801-3815) |
Appendix 05 |
Certificate of Authority Application Cover Sheet |
Appendix 06 |
Crosswalk Forms for Department of Health Requirements |
Appendix 07 |
Insurance Department Checklist - Guidelines/Technical Advice Regarding Health Insurance Forms |
Appendix 08 |
Guidelines/Technical Advice in Developing Provider Contracts |
Appendix 09 |
Insurance Department List of Mandated Health Insurance Benefits |
Appendix 10 |
Department of Health and Insurance Department Statements of Policy on Integrated Delivery Systems |
Appendix 11 |
Department of Health Advisory Regarding HMO Contracting to Serve Medical Assistance Patients |
Appendix 12 |
Department of Health Technical Advisory Regarding Exemption Requests for CRNPs to Serve as Primary Care Providers |
Appendix 13 |
Guidelines, Procedures and Regulations for Developing a Member Grievance System |
Appendix 14 |
Guidelines/Technical Advice in Developing a Quality Assurance Plan |
Appendix 15 |
Guidelines for Developing Credentialing System |
Appendix 16 |
General Outline and Agenda for Department of Health On-Site Review |
Appendix 17 |
Department of Health HMO Quarterly and Annual Reporting Instructions and Forms |
Appendix 18 |
Department of Health and Insurance Department Joint Policy Statement - HMO Point-of-Service Products and Gatekeeper PPOs |
Appendix 19 |
Insurance Department Memo Regarding Minimum Capital and Surplus Requirements for Licensure of HMOs |
Appendix 20 |
Insurance Department Guidelines/Technical Advice Regarding the Development of a Business Plan for Newly Formed HMOs |
Appendix 21 |
Insurance Department Guidelines/Technical Advice Regarding Rates |
Appendix 22 |
General Outline and Agenda for Insurance Department Organizational Exam |
Appendix 23 |
Department of Health List of Approved External Quality Review Organizations |
Appendix 24 |
Department of Health List and Insurance Department Service Area Expansion Guidelines |