37.86.5027    HEALTH MAINTENANCE ORGANIZATIONS: RECIPIENT EDUCATION

(1) An HMO must have written instructions for enrollees in the use of all services provided. The policy must include, but is not limited to, written information on service restrictions and limitations regarding appropriate use of the referral system, grievance procedure, after hours call-in system, provisions for emergency treatment, how the enrollee may obtain services that are the responsibility of the HMO under ARM 37.86.5007 and the contract between the HMO and the department but which are not available through the HMO due to religious objections and how to request a list of the HMO's participating providers.

History: Sec. 53-2-201 and 53-6-113, MCA; IMP, Sec. 53-2-201, 53-6-101, 53-6-113 and 53-6-116, MCA; NEW, 1995 MAR p. 1974, Eff. 9/29/95; AMD, 1997 MAR p. 1210, Eff. 7/8/97; TRANS, from SRS, 2000 MAR p. 481.