Prime Health Services maintains a Compliance Department to ensure that Prime Health and Prime Health’s clients remain in compliance with each state’s ever-changing laws, rules, regulations, and court decisions. Most state legislatures meet from January through May each year, which is when decisions are made regarding existing law and new or proposed laws. Some states (e.g., Texas) have legislatures that meet only every other year, so these states have very powerful commissioners who can more quickly and easily change state regulations.
One of the primary goals of our Compliance Department is to keep our company and clients well informed of the decisions made by these state legislatures and commissioners. Another role of our Compliance Department is to handle state certifications and filings. Some states have adopted legislation that governs provider networks and or managed care organizations (MCO) in an effort to control their workers’ compensation costs.
Each state’s network and MCO regulations are different, which is why Prime Health’s state offerings and certifications vary state-to-state as well. Similarly, many of the states that require network or MCO certifications also require frequent updates or filings to their state regulatory departments. Such filings may be annual, bi-annual, or even quarterly, and our Compliance Department works hard to keep us well informed and compliant under the strict timeframes.
Our continuous evaluation of the regulations that govern these state certifications and filings allows our company and clients to offer the most up-to-date and progressive services and products to our customers. Prime Health works hard to remain in compliance with the various requirements of our local, state, and federal governments and court systems, which is why our Compliance Department is a good resource for our company and clients.