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. (1) that records related to the requirements of Insurance Code Chapter 1272, Subchapter D, must be accessible at all times to the HMO;
2. (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. (3) making the records described in paragraph (1) of this section available to the department on request; and
4. (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.

Source Note:The provisions of this §11.2609 adopted to be effective August 1, 2017, 42 TexReg 2169.