11 NCAC 20 .0501             PROGRAM

(a)  Each HMO shall have a program designed to monitor, evaluate, improve, and promote:

(1)           The quality of health care and quality of services provided through its network of providers; and

(2)           Its policies, procedures, and performance.

(b)  The program shall identify those areas and aspects of health care covered by the HMO's benefit plan or plans that are included in its quality management program.


History Note:        Authority G.S. 58-2-40(1); 58-67-5; 58-67-10; 58-67-20; 58-67-35; 58-67-65; 58-67-140; 58-67-150;

Eff. October 1, 1996;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 16, 2014.