Pennsylvania Code & Bulletin

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 53 Pa.B. 6142 (September 30, 2023).

31 Pa. Code § 152.19. Annual reporting requirements.

§ 152.19. Annual reporting requirements.

 An approved risk-assuming preferred provider organization shall file with the Secretary and the Commissioner on or before March 31 of each year an annual report of its activities during the prior calendar year. Annual reports include:

   (1)  A copy of the annual financial statement required by §  152.21 (relating to financial statements and examinations).

   (2)  A description of results in its quality assurance activities undertaken during the year.

   (3)  A summary of the number of covered persons in the preferred provider organization.

   (4)  A summary of total number of grievances handled, a compilation of causes underlying the grievances and the resolution of grievances.

   (5)  A summary of utilization experience of the preferred provider organization.

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