Use of freestanding urgent care centers; policies




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20107720-1077.  Use of freestanding urgent care centers; policies

A health care services organization that requires its enrollees to use a freestanding urgent care center as a condition of coverage or a reduction in copayment, coinsurance or deductible amounts for covered health care services shall:

1.  Develop and maintain policies for the appropriate referral of its enrollees to freestanding urgent care centers.  The health care services organization's medical director shall approve these policies.

2.  Inform its enrollees through an appropriate means as to when to seek care at a freestanding urgent care center instead of using a higher level of care, such as a hospital emergency department.



3.  At least every two years, review the performance of and recredential the freestanding urgent care centers under contract with the health care services organization.201077



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