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ROBERT L. EHRLICH, JR., Governor
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Ch. 443
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neurosurgery, orthopedics, surgery and
emergency medicine.
Further provided that $28,779 of this
appropriation shall be reduced contingent
upon the enactment of legislation
authorizing the Department of Health
and Mental Hygiene to seek recovery from
the estate of the spouse of a deceased
Medicaid recipient for the cost of
furnishing Medicaid services.
Further provided that $4,000,000 of this
appropriation may not be expended until
the Department of Health and Mental
Hygiene (DHMH): (1) selects a minimum
of eight measures of managed care
organization performance and establishes
calendar 2005 performance targets for
each of the measures, including minimum
performance targets and targets for high
performing managed care organizations:
(2) implements procedures for
withholding $4,000,000 in total funds
from the capitation payments made to
managed care organizations during the
period from January 2006 through June
2006; and (3) develops a methodology for
distributing the withheld capitation
payments to managed care organizations
that meet or exceed the calendar 2005
minimum performance targets.
Further provided that $2,000,000 of this
appropriation for capitation payments to
managed care organizations may only he
expended to provide incentive payments
to managed care organizations that meet
or exceed the calendar 2005 minimum
performance targets established by
DHMH.
It is the intent of the General Assembly that
managed care organizations meeting or
exceeding the minimum performance
receive incentive payments equivalent to
the amount that was withheld from them.
Any remaining withheld funds should he
allocated exclusively to managed care
- 2195 -
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