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6.6.5802    CRITERIA FOR ASSESSING THE FINANCIAL SOUNDNESS OF A NETWORK

(1) The standards used for evaluating the financial condition of regulated companies found in ARM 6.6.3401(1) (a) and (c) through (o) may be used by the commissioner in evaluating the financial soundness of a network.

(2) For the purposes of assessing the financial soundness of a network, the commissioner may use the same discretionary authority available to him pursuant to ARM 6.6.3402, as regards insurers.

(3) In making his determination of the financial soundness of a network, the commissioner must consider the following:

(a) The extent to which a network is composed of providers who directly render health care and are located within the community in which they seek to contract rather than solely arrange or finance the delivery of health care;

(b) The following risk-bearing and management techniques:

(i) hold harmless agreements with health care providers;

(ii) reinsurance protection from sound reinsurers, provided to the network; and

(iii) guaranties by others, to the extent that the guarantor appears capable of fulfilling the guaranty; and

(c) The amount of the net worth of the network as reported in its most recent financial statement.

(4) A network which does not comply with the minimum net worth standard of $200,000.00, found in 33-31-216 (9) , MCA, shall be considered financially unsound.

History: Sec. 53-6-703(3), MCA; IMP, Sec. 53-6-703, MCA; NEW, 1995 MAR p. 2675, Eff. 12/8/95.

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