An HMO shall notify all affected group contract holders in writing of a substantive change in the payment arrangement for physicians and providers within 30 days of any change in the type of payment arrangement changes, e.g., from capitation to fee for service, from fee for service to capitation, for any type of service. The notification of the change must include a description of the payment arrangement that has been changed and a description of the new payment arrangement.

Source Note:The provisions of this §11.1603 adopted to be effective November 2, 1998, 23 TexReg 11347.