(a) An HMO's delegation of functions to an HCC is subject
to the requirements of Insurance Code Chapter 1272 and Chapter 11,
Subchapter AA of this title (relating to Delegated Entities).
(b) An insurer's delegation of functions to an HCC
is subject to the requirements of Insurance Code Chapter 1272 and
Chapter 11, Subchapter AA of this title as if the insurer were an
HMO.
(c) If a provision of this subchapter imposes a compliance
requirement that is greater than or in conflict with those contained
in Insurance Code Chapter 1272 or Chapter 11, Subchapter AA of this
title, the requirement of this subchapter governs.
(d) A delegation agreement between an HMO or insurer
and an HCC must mandate that the HMO or insurer disclose in all provider
listings distributed to insureds or enrollees those providers participating
in the HCC within the HMO's or insurer's approved service area.
(e) If an insurer contracts for services with an HCC
on a basis other than fee-for-service, the insurer must disclose the
nature of its payment arrangement with the HCC in either the insurance
policy and certificates or in any provider listing distributed to
insureds.
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