Regulation .02 Benefits — Primary Care Services.
Regulation .02 Benefits — Primary Care Services.LinkCopy Citation
An MCO shall provide to its enrollees medically necessary primary care services that are provided:
A.
By the enrollee's PCP;
B.
At the direction of the enrollee's PCP; or
C.
With respect to a primary care service that is self-referred pursuant to Regulation .28 of this chapter:
(1)
By an appropriate practitioner, acting within the scope of the practitioner's license, certification, or other legal authorization, and in accordance with the practitioner's training and experience; or
(2)
By a clinic that furnishes health care services by or under the direction of a physician.