Delaware Code Title 18 Sec. 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.
Terms Used In Delaware Code Title 18 Sec. 6410
- Certified managed care organization: means a managed care organization which has been issued a certificate of authority under this title. See Delaware Code Title 18 Sec. 6403
- Contract: A legal written agreement that becomes binding when signed.
- Department: means the Delaware Department of Insurance. See Delaware Code Title 18 Sec. 6403
- Health-care services: means any service included in the furnishing to any individual of medical or dental care, or hospitalization or incidental to the furnishing of such care or hospitalization, as well as the furnishing to any person of any and all other services for the purpose of preventing, alleviating, curing or healing human illness, injury or physical disability. See Delaware Code Title 18 Sec. 6403
- Managed care organization: means a public or private organization, organized under the laws of any state, which:
- State: means the State of Delaware; and when applied to different parts of the United States, it includes the District of Columbia and the several territories and possessions of the United States. See Delaware Code Title 1 Sec. 302
- Statute: A law passed by a legislature.
(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.
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;