New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 24B - ORGANIZED DELIVERY SYSTEMS
Subchapter 3 - FUNCTIONAL OBLIGATIONS OF AN ORGANIZED DELIVERY SYSTEM
Section 11:24B-3.2 - Carriers: limitations on delegation
Current through Register Vol. 56, No. 6, March 18, 2024
(a) Carriers shall only delegate the performance of those functions set forth at 11:24B-2.4(a), as further described in this subchapter, to a CODS certified for those functions.
(b) A carrier may contract with an entity to perform less than a majority of the duties specified for a function as set forth within this subchapter, in which event, the entity performing those specific duties need not be certified to perform the function in order to contract with the carrier, and the carrier will not be considered to have delegated that function in accordance with this chapter.
(c) Use by a carrier of an ODS' network shall not relieve the carrier of any obligation it may have regarding nondiscrimination against specified providers, inclusion of specified providers within its network(s), or accessibility of specified providers to covered persons pursuant to statute or regulation.