36-2990. Quality of health care monitoring standard; development; adoption; use; additional monitoring; costs

A. The administration shall develop standards of care that each contractor shall use to monitor the quality of health care received by members.

B. The director shall periodically determine whether each contractor has properly adopted and implemented standards to ensure the quality of health care. If the director determines that a contractor is out of compliance, the director shall undertake additional efforts to monitor and assess the quality of health care provided by that contractor for the period of time that the director deems necessary. The director shall determine the cost incurred in undertaking these special efforts and shall deduct that amount from any payment owed to the contractor.

36-2990. Quality of health care monitoring standard; development; adoption; use; additional monitoring; costs

A. The administration shall develop standards of care that each contractor shall use to monitor the quality of health care received by members.

B. The director shall periodically determine whether each contractor has properly adopted and implemented standards to ensure the quality of health care. If the director determines that a contractor is out of compliance, the director shall undertake additional efforts to monitor and assess the quality of health care provided by that contractor for the period of time that the director deems necessary. The director shall determine the cost incurred in undertaking these special efforts and shall deduct that amount from any payment owed to the contractor.