Section 230-RICR-20-30-6.5 - Complete Claim StandardA. Each subject entity operating in this state shall establish a written standard defining a complete claim.B. Each subject entity operating in this state shall distribute its complete claim standard to all participating providers.C. Each subject entity operating in this state shall make an initial filing of its complete claim standard with the OHIC within ninety days of January 1, 2007. When filing its initial complete claim standard, an officer of the subject entity must certify that, to the best of his or her knowledge, all participating providers have been provided a copy of the complete claim standard.D. If a subject entity intends to commence operations in this state after January 1, 2007, the subject entity must make an initial filing of its complete claim standard with the OHIC prior to commencing operations. When filing its initial complete claim standard, an officer of the subject entity must certify that, to the best of his or her knowledge, all participating providers have been provided a copy of the complete claim standard.E. If a subject entity intends to amend its complete claim standard after filing its initial complete claim standard as required by § 6.5(C) or (D) of this Part, the subject entity shall 1. provide a copy of the amended complete claim standard to participating providers at least thirty calendar days before the effective date of the amended complete claim standard;2. file the amended complete claim standard with the OHIC at least thirty calendar days before the effective date of the amended complete claim standard; and3. file a certification by an officer of the subject entity that, to the best of his or her knowledge, all participating providers have been provided a copy of the amended complete claim standard.F. Examples 1. Example 1. A subject entity operates in Rhode Island as of January 1, 2007. All of the subject entity's participating providers have been provided a copy of the complete claim standard. Within ninety days of the January 1, 2007, the subject entity must file with this Office: a copy of the complete claim standard and a certification by an officer of the subject entity that, to the best of his or her knowledge, all participating providers have been provided a copy of the complete claim standard. Thereafter, unless the subject entity intends to amend or change its complete claim standard, no additional filings are required with respect to the complete claim standard.2. Example 2. A subject entity plans to begin operations in Rhode Island after January 1, 2007. At least thirty days prior to commencing operations, the subject entity must: provide a copy of the complete claim standard to all network providers, file with this Office a copy of the complete claim standard and file with this Office a certification by an officer of the subject entity that, to the best of his or her knowledge, all participating providers have been provided a copy of the complete claim standard. Thereafter, unless the subject entity intends to amend or change its complete claim standard, no additional filings are required with respect to the complete claim standard.3. Example 3. A subject entity operating in Rhode Island makes a timely initial complete claim standard filing after January 1, 2007. Thereafter, the subject entity wants to amend its complete claim standard. At least thirty days prior to the effective date of the amended standard, the subject entity must: a. provide a copy of the amended complete claim standard to all network providers, b. file with this Office a copy of the amended complete claim standard, and c. file with this Office a certification by an officer of the subject entity that, to the best of his or her knowledge, all participating providers have been provided a copy of the amended complete claim standard. Thereafter, unless the subject entity intends to further amend or change its complete claim standard, no additional filings are required with respect to the complete claim standard.230 R.I. Code R. 230-RICR-20-30-6.5