59A-12.008. Referral Procedures

Effective on Wednesday, March 11, 1992

1Each HMO or PHC must have in place:

9(1) A system to facilitate referral of subscribers to contracted or non-contracted physician and hospital providers; and, in the case of non-contracted providers, include a procedure for prior authorization and written notification regarding such referral to the subscriber.

47(2) A means for notifying the subscribers of the referral system, including the procedures for the subscribers to obtain a second medical opinion. Such notification shall be clearly stated in either the subscriber contract, member handbook or other written communication.

87Rulemaking Authority 89641.56 FS. 91Law Implemented 93641.51(4), 94641.495(3) FS. 96History–New 1-28-88, Amended 3-11-92, Formerly 10D-100.008.

Related Statutes:

                    
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