Sec. 38a-479dd. Preferred provider network examination of outstanding amounts. Notice. Commissioner's duties.
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Sec. 38a-479dd. Preferred provider network examination of outstanding
amounts. Notice. Commissioner's duties. Each preferred provider network shall examine its outstanding amounts in each quarter and if the preferred provider network
determines that the outstanding amounts in a quarter will exceed ninety-five per cent
of the security posted pursuant to subsection (i) of section 38a-479aa, the preferred
provider network shall mail a notice to each of its participating providers concerning
the status of incurred claims and shall send notice to each managed care organization
with which it contracts and the Insurance Commissioner on such form as the commissioner prescribes. The commissioner shall meet with the applicable managed care organization and preferred provider network to ensure continued services to enrollees and
payment to providers.