405 IAC 11-1-17 "Risk-based managed care" or "RBMC" defined

Sec. 17. "Risk-based managed care" or "RBMC" means a fully capitated prepayment plan where a managed care organization, under a contract with the office, is at risk to arrange for and administer the provision of a comprehensive set of covered services to CHIP members. Members are linked to a PMP who contracts directly with the MCO.