Effective – 13 May 2005 208.431. Medicaid managed care organization reimbursement allowance, amount. — 1. For purposes of sections 208.431 to 208.437, the following terms mean: (1) “Engaging in the business of providing health benefit services”, accepting payment for health benefit services; (2) “Medicaid managed care organization”, a health benefit plan, as defined in section […]
Effective – 13 May 2005 208.432. Record keeping required, submission to department. — Each Medicaid managed care organization shall keep such records as may be necessary to determine the amount of its reimbursement allowance. Every Medicaid managed care organization shall submit to the department of social services a statement that accurately reflects such information as […]
Effective – 13 May 2005 208.433. Calculation of reimbursement allowance amount — notification of Medicaid managed care organizations — offset permitted, when. — 1. The director of the department of social services shall make a determination as to the amount of Medicaid managed care organization’s reimbursement allowance due from each Medicaid managed care organization. 2. […]
Effective – 13 May 2005 208.434. Amount final, when — protest, procedure. — 1. Each Medicaid managed care organization reimbursement allowance determination shall be final after receipt of written notice from the department of social services, unless the Medicaid managed care organization files a protest with the director of the department of social services setting […]
Effective – 13 May 2005 208.435. Rulemaking authority. — 1. The department of social services shall promulgate rules, including emergency rules if necessary, to implement the provisions of sections 208.431 to 208.437, including but not limited to: (1) The form and content of any documents required to be filed under sections 208.431 to 208.437; (2) […]
Effective – 13 May 2005 208.436. Remittance to the department — deposit in dedicated fund. — 1. (1) The Medicaid managed care organization reimbursement allowance owed or, if an offset has been requested, the balance, if any, after such offset, shall be remitted by the managed care organization to the department of social services. The […]
Effective – 28 Sep 2021, 11 histories 208.437. Reimbursement allowance period — notification of balance due, when — delinquent payments, procedure, basis for denial of licensure — expiration date. — 1. A Medicaid managed care organization reimbursement allowance period as provided in sections 208.431 to 208.437 shall be from the first day of July to […]
