Foundation Health Plan, Inc et al., Case No. 829265-2, except that the Court shall retain jurisdiction to enforce the Agreement and the Dispute Resolution provisions
Foundation Health Plan, Inc. Hawaii Region On May 21,1991, we issued a letter of noncompliance to Xxxxxx Foundation Health Plan, Inc., Hawaii Region. We initiated the compliance action because of Xxxxxx’x policy imposing impermissible limits on home health benefits. Neither title XIII of the Act nor Health Plan of Massachusetts, Inc. We initiated the compliance action because of Xxxxxx’x policy imposing impermissible limits on home health benefits. Neither title XIII of the Public Health Service Act nor the regulations permit a Federally qualified HMO to place across-the-board time or cost limitations on medically necessary, prescribed home health services for commercial (non-Medicare/Medicaid) enrollees. W e directed Xxxxxx to amend its subscriber agreement to eliminate the impermissible limits, to notify its members and providers of the change, and to submit a draft of the revised subscriber agreement and a copy of the notice to members and providers to the Office of Prepaid Health Care Operations and Oversight.
