§ 6410 — Provision of professional services

(a) A managed care organization shall have a medical director. The medical director shall be licensed to practice medicine in Delaware in accordance with § 1702 of Title 24. The medical director’s duties shall include, at a minimum, those specified in regulations promulgated by the Department pursuant to the authority granted. The medical director may assign duties to other physicians and nonphysician personnel employed by, or under contract to, the managed care organization, provided, however, that the medical director shall retain responsibility for assigned duties. Any decision to deny a covered service shall be rendered by a physician.

(b) A certified managed care organization may contract with, or employ, any licensed health-care professional to provide health-care services, notwithstanding any statute, rule or regulation to the contrary. No managed care organization delivering health-care services in this State shall engage in a contract with or employ, for the delivery of such services, any person who does not hold a Delaware license to practice the profession for which such person is engaged or employed, if such practice requires a license.

Legislative History

63 Del. Laws, c. 382, § 1 ; 66 Del. Laws, c. 124, §§ 7, 11-15 ; 71 Del. Laws, c. 229, §§ 1, 7 ; 72 Del. Laws, c. 200, §§ 1, 2 ; 75 Del. Laws, c. 362, § 2