(a) Each prepaid limited health service organization shall have in writing a quality assurance program approved by the commissioner which describes the program's objectives, organization and problem solving activities. (b) The scope of the quality assurance program shall include, at a minimum: (1) Organizational arrangements and responsibilities for quality management and improvement processes; (2) A documented utilization management program; (3) Written policies and procedures for credentialing and recredentialing physicians and other licensed providers who fall under the scope of auathority of the prepaid limited health service organization; (4) A written policy that addresses enrollees' rights and responsibilities; (5) The adoption of practice guidelines for the use of preventive health services; and (6) Any other criteria considered necessary by the commissioner. (c) This section becomes effecetive on May 1, 1999.
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