Administrative Code

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Virginia Administrative Code
Title 12. Health
Agency 5. Department of Health
Chapter 408. Certificate of Quality Assurance of Managed Care Health Insurance Plan Licensees

12VAC5-408-290. Health promotion.

A. Annually, the MCHIP licensee shall develop and implement at least one health guideline for the prevention and early detection of illness and disease. Each written guideline shall:

1. Be available to covered persons upon request;

2. Describe the prevention or early detection intervention and the recommended frequency and condition under which the intervention is required; and

3. Document the scientific basis or authority upon which the guideline is based.

Guidelines may be specific to a defined population segment.

B. The MCHIP licensee shall distribute any preventive health guideline it develops and any updates to its providers as soon as practicable after development of the guideline.

C. The MCHIP shall regularly communicate with its covered persons to encourage the use of preventive health services.

D. At least annually, the MCHIP licensee shall measure covered person and provider compliance with the current preventive care guidelines. The MCHIP licensee may measure compliance by population segment if the guideline is specific to a population segment.

E. Providers who have appropriate knowledge shall be consulted in the adoption of the preventive health guidelines.

Statutory Authority

§ 32.1-137.1 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 16, Issue 7, eff. January 20, 2000; amended, Virginia Register Volume 18, Issue 8, eff. January 30, 2002.

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