WAC 388-538-0067

Effective January 14, 2002

WAC 388-538-0067 Managed care provided through managed care organizations (MCOs)

  1. Managed care organizations (MCOs) may contract with the department of social and health services (DSHS) to provide prepaid health care services to eligible medical assistance administration (MAA) clients under the healthy options (HO) managed care program. The MCOs must meet the qualifications in this section to be eligible to contract with DSHS. The MCO must:

    1. Have a certificate of registration from the office of the insurance commissioner (OIC) as either a health maintenance organization (HMO) or a health care services contractor (HCSC). 

    2. Accept the terms and conditions of DSHS' HO contract;

    3. Be able to meet the network and quality standards established by DSHS; and

    4. Accept the prepaid rates published by DSHS.

  2. DSHS reserves the right not to contract with any otherwise qualified MCO.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.