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(d) The Department will have access to medical records of plan enrollees for the purpose of determining the quality of care, investigating complaints or grievances, enforcement, or other activities relating to ensuring compliance with Article XXI, this chapter or other laws of the Commonwealth. A network is required for issuance of a certificate of authority.
Provider network The health care providers designated by a plan to provide health care services to enrollees. (6) A statement of the number of physicians leaving the plan and of the number of physicians joining the plan. CREDENTIALING 9.761 The provisions of this Chapter 9 issued under the Health Maintenance Organization Act (40 P. § § 15511567); and section 2102(a) and (g) of The Administrative Code of 1929 (71 P. (5) A copy of the plans current provider directory. (4) A copy of the current enrollee literature, including subscription agreements, enrollee handbooks and any mass communications to enrollees concerning complaint and grievance rights and procedures. Code § 152.8 (relating to compliance with Health Maintenance Organization Act (40 P. empty Construction Medical institutions or groups not specifically identified by the legislature will not be included in the Pennsylvania Peer Review Protection Act (63 P. (3) The number, type, and disposition of all complaints and grievances filed with the plan or subcontractors.
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(8) Copies of the currently utilized generic or standard form health care provider contracts including copies of any deviations from the standard contracts and reimbursement methodologies.