| (a) After receipt of a certificate of authority, no
evidence of coverage filing may be amended or altered in any manner,
and no new evidence of coverage filing may be used, unless the proposed
new or revised evidence of coverage filing has been filed for review
and has received the approval of the commissioner. The evidence of
coverage must be filed as provided in §11.301 of this title (relating
to Filing Requirements).
(b) The department will notify the HMO of the department's
action in compliance with §1.704 of this title (relating to Summary
Procedure; Notice).
(c) The department will base its approval or disapproval
on the content of drafts submitted to the department. Filings must
comply with the specifications described in §11.505 of this title
(relating to Specifications for the Evidence of Coverage and Matrix
Filings). Any discrepancy in content between the final document to
be issued and the approved draft is grounds for revocation of the
certificate of authority.
(d) The review period for an evidence of coverage filing
begins on the date an acceptable, typed draft of the form is received.
(e) The review period may be extended on 30-days written
notice of extension to the HMO before the expiration of the initial
review period.
(f) At the end of the review period, the evidence of
coverage filing is considered approved unless it has already been
withdrawn, affirmatively approved, or disapproved by the commissioner.
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