SHMTL 16 (New rule 5101:6-2-37 "Notices of enrollment, continued enrollment, or provider change denial for the managed care plan controlled substances and member management program")
State Hearings Manual Transmittal Letter No. 16
April 23, 2009
TO: State Hearings Manual (SHM) Holders
FROM: Douglas E. Lumpkin, Director
SUBJECT: New rule 5101:6-2-37 "Notices of enrollment, continued enrollment, or provider change denial for the managed care plan controlled substances and member management program"

This letter transmits new rule 5101:6-2-37 "Notices of enrollment, continued enrollment, or provider change denial for the managed care plan controlled substances and member management program," effective May 1, 2009.

Rule 5101:6-2-37 was adopted to describe notices to and hearing rights for individuals enrolled by a Medicaid managed care plan (MCP) in the controlled substances and member management (CSMM) program defined in rule 5101:3-26-01 and authorized by section 5111.172 of the Revised Code. The rule requires an MCP to provide written notification and hearing rights when it enrolls an individual in the CSMM program, determines that enrollment for an individual already in the CSMM program should continue, or denies an individual's request for a change in that individual's designated provider.

Instructions:

LocationRemove and File as ObsoleteInsert
SHM 1000
State Hearings Policy 		n/a 5101:6‑2‑37
effective 5/1/09