Ohio Administrative Code
Title 4123 - Bureau of Workers' Compensation
Chapter 4123-6 - Health Partnership Program
Section 4123-6-03.7 - MCO participation in the HPP - bureau's authority to decertify, to refuse to certify or recertify an MCO

Universal Citation: OH Admin Code 4123-6-03.7

Current through all regulations passed and filed through September 16, 2024

(A) Should the administrator determine that sufficient evidence exists that an MCO has failed to maintain any of the requirements set forth in division (F) of section 4121.44 of the Revised Code, or to reasonably comply with or to perform in accordance with the terms of a contract between the bureau and the MCO entered into pursuant to division (B)(4) of section 4121.44 of the Revised Code, or has violated a rule adopted under section 4121.441 of the Revised Code, the administrator has the authority to decertify, or refuse to certify or recertify an MCO, in accordance with rule 4123-6-17 of the Administrative Code and Chapter 119. of the Revised Code.

(B) Upon a final order of the administrator to decertify, or refuse to recertify an MCO, employees and employers shall not receive services from such MCO pursuant to the HPP.

(C) Upon a final order of the administrator to decertify or refuse to recertify an MCO, any obligation of a provider to provide services under the HPP pursuant to a contract or agreement with such MCO shall be null and void.

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