| (a) A network may not enter into a contract with another
entity for management services, or modify a previously approved management
contract, unless the proposed contract or modification is first filed
with the department and approved by the Commissioner in accordance
with Insurance Code §1305.102, concerning Management Contracts.
(b) For purposes of this chapter, management services
include management control and decision-making, and contracting on
behalf of the network under a delegation of management authority,
power of attorney, or other arrangement.
(c) If a person is serving as both a management contractor
or a third party to which the network delegates a function and as
an agent of the health care provider, the contract between the management
contractor or third party and the health care provider must comply
with Insurance Code §1305.153, concerning Provider Reimbursement.
(d) A management contractor or a third party that is
also serving as an agent for one or more health care providers in
the certified network must meet the disclosure requirements with the
certified network under Insurance Code §1305.153.
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