WAC 388-538-067   Managed care provided through managed care organizations (MCOs).  (1) Managed care organizations (MCOs) may contract with the department to provide prepaid healthcare services to eligible clients. The MCOs must meet the qualifications in this section to be eligible to contract with the department. The MCO must:

     (a) Have a certificate of registration from the office of the insurance commissioner (OIC) that allows the MCO to provide the healthcare services;

     (b) Accept the terms and conditions of the department's managed care contract;

     (c) Be able to meet the network and quality standards established by the department; and

     (d) Accept the prepaid rates published by the department.

     (2) The department reserves the right not to contract with any otherwise qualified MCO.



[Statutory Authority: RCW 74.08.090 and 74.09.522. 08-15-110, § 388-538-067, filed 7/18/08, effective 8/18/08; 06-03-081, § 388-538-067, filed 1/12/06, effective 2/12/06. Statutory Authority: RCW 74.08.090, 74.09.522, 2003 E1 c 25 § 201(4), 2004 c 276 § 201(4), 42 USC 1396N (section 1915 (b) and (c) of the Social Security Act of 1924). 05-01-066, § 388-538-067, filed 12/8/04, effective 1/8/05. Statutory Authority: RCW 74.08.090, 74.09.522. 03-18-112, § 388-538-067, filed 9/2/03, effective 10/3/03. Statutory Authority: RCW 74.09.080, RCW 74.08.510, [74.08.]522,74.09.450 , 1115 Waiver, 42 U.S.C. 1396. 02-01-075, § 388-538-067, filed 12/14/01, effective 1/14/02.]