New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 24B - ORGANIZED DELIVERY SYSTEMS
Subchapter 3 - FUNCTIONAL OBLIGATIONS OF AN ORGANIZED DELIVERY SYSTEM
- Section 11:24B-3.1 - Carriers and CODS: mutual obligation to comply fully with certain standards
- Section 11:24B-3.2 - Carriers: limitations on delegation
- Section 11:24B-3.3 - CODS and LODS: Application of statutes and regulations
- Section 11:24B-3.4 - ODS: performance of health care services
- Section 11:24B-3.5 - ODS: network management
- Section 11:24B-3.6 - ODS: credentialing
- Section 11:24B-3.7 - ODS: utilization management guidelines development
- Section 11:24B-3.8 - ODS: utilization management program
- Section 11:24B-3.9 - Utilization management appeal mechanism
- Section 11:24B-3.10 - ODS: continuous quality improvement
- Section 11:24B-3.11 - ODS: provider complaint mechanism
- Section 11:24B-3.12 - ODS: member complaint mechanism
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