D.C. Mun. Regs. tit. 26, r. 26-A4707

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 26-A4707 - FILING REQUIREMENTS FOR CARRIER - PROVIDER AND INTERMEDIARY CONTRACTS

4707.1

At the time a health carrier files its initial Access Plan or subsequently, the health carrier shall file as part of the Access Plan, with the Commissioner:

(a) Sample (template) contract forms proposed for use with its participating providers and intermediaries, excluding downstream vendor contracts.

(b) At least thirty (30) days prior to use, a health carrier shall submit any material changes to a contract that would affect a provision required under this chapter to the Commissioner through the System for Electronic Rate and Form Filing ("SERFF").

(c) A health carrier shall provide copies of provider and intermediary contracts to the Commissioner for regulatory review within twenty (20) days of receiving written notice and maintain the provider and intermediary contracts at its principal place of business, or otherwise having access to all of those contracts.

4707.2

The execution of a contract by a health carrier shall not relieve the health carrier of its liability to any person with whom it has contracted for the provision of services or of its responsibility for compliance with District of Columbia law or this chapter.

4707.3

All contracts between carriers and providers or facilities shall be in writing and subject to review by the Commissioner upon request.

D.C. Mun. Regs. tit. 26, r. 26-A4707

Final Rulemaking published at 70 DCR 2231 (2/17/2023)