In addition to any other requirements set forth in this subchapter,
an HMO that contracts with a delegated network must ensure that the
delegated network complies with Insurance Code Chapter 1272, Subchapter
D, (concerning Reserve Requirements). The HMO's agreement with the
delegated network must include a provision:
(1) that records related to the requirements of Insurance
Code Chapter 1272, Subchapter D, must be accessible at all times to
the HMO;
(2) requiring all financial records and related information
necessary to show the delegated network's compliance with the requirements
of Insurance Code Chapter 1272, Subchapter D;
(3) making the records described in paragraph (1) of
this section available to the department on request; and
(4) that records be kept providing evidence that the
HMO has adequately monitored the delegated network for compliance
with the requirements of Insurance Code Chapter 1272, Subchapter D.
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