Certification Renewal Process

​​(based on ARM 24.29.2361)

1. MCO sends renewal notice to Montana Department of Labor (60 to 120 days before expiration).

2. MCO must be current in all reporting requirements (ARM 24.29.2351):

A. Copy of MCO-insurer contract(s).
B. Copy of service contracts or modifications within 10 days of signing.
C. Copy of contracts with other entities to perform some functions of the plan within 30 days of signing.
D. Addition or termination of members within 30 days.
E. Change in licensure of members or staff within 30 days.
F. Changes in administrative staff within 30 days.
G. Changes in service location within 30 days.;
H. Expiration, termination, or cancellation of any service contract within 30 days.
I. Annual report (ARM 24.29.2351 (5) --- see separate information sheet).
J. Report any data required to comply with reporting requirements of the Department of Labor.
K. Report any additional information required by the Department of Labor.
 

3. MCO Certification Renewal Application will contain:

​A. Statement: MCO not formed, owned, or operated by WC insurer or self-insured​ employer; statement must be signed by day-to-day administrator.
B. Liaison’s name, title, address, telephone number and email address.
C. Day-to-day administrator’s name, title, address, telephone number and email address.
D. Medical director’s (if any) name, title, address, telephone number and email address.
E. Current members’ names, specialty, addresses, telephone numbers and email addresses. (Medical director or day-to-day administrator must include signed statement that each individual listed is properly licensed)
F. List of insurers contracted with, including expiration dates of contracts.
G. Summary of any sanctions or punitive actions taken by MCO against members.​