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.

Terms Used In Arizona Laws 36-2903.02

  • Administration: means the Arizona health care cost containment system administration. See Arizona Laws 36-2901
  • Contractor: means a person or entity that has a prepaid capitated contract with the administration pursuant to section 36-2904 or chapter 34 of this title to provide health care to members under this article or persons under chapter 34 of this title either directly or through subcontracts with providers. See Arizona Laws 36-2901
  • Director: means the director of the Arizona health care cost containment system administration. See Arizona Laws 36-2901
  • Month: means a calendar month unless otherwise expressed. See Arizona Laws 1-215

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.

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