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.