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Florida Administrative Code (Last Updated: April 18, 2024) |
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59. Agency for Health Care Administration |
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59A. Health Facility and Agency Licensing |
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59A-12. Health Maintenance Organizations And Prepaid Health Clinics |
1(1) Each HMO or PHC shall have a governing body that sets policy and has overall responsibility for the organization including the following:
24(a) Adopting organizational bylaws, rules and regulations or similar form of document which provides a clear concise statement of the mission, goals, and objectives of the organization;
51(b) Adopting a quality assurance program that monitors the key areas of health care delivery to identify problems and insure the early recognition of opportunities to improve the delivery of quality health care services; and
86(c) Maintaining ultimate responsibility for ongoing quality assurance, risk management programs and credentialing programs.
100(2) Nothing in this rule shall prohibit the designation of qualified management personnel to implement the provisions of subsection (1) and to manage the operation of the HMO or PHC in the geographic area or areas serviced. The relationship between management personnel and the governing body shall be set forth in writing including each person’s authority, responsibilities and functions.
159Rulemaking Authority 161641.56 FS. 163Law Implemented 165641.22, 166641.49, 167641.49(3) FS. 169History–New 1-28-88, Formerly 10D-100.004, Amended 4-10-03.
