36-2903.02

36-2903.02. Quality of health care monitoring standard; development; adoption; use; additional monitoring; costs

A. The administration shall develop by rule a standard for contractors to use to monitor the quality of health care received by members. Each contractor shall adopt and use the standard developed by the administration.

B. The director shall periodically determine whether each contractor has properly adopted and implemented the quality of health care monitoring standard. If the director determines that a contractor has not done so, the director shall undertake additional special efforts to monitor and assess the quality of health care provided by that contractor for as long as the director deems necessary. The director shall determine the cost incurred in undertaking such special efforts and shall deduct that amount each month from any payment owed to that contractor for as long as the special efforts continue.