PARRIS N. GLENDENING, Governor                             Ch. 352

(vi) Provide or assure alcohol and drug abuse treatment for substance
abusing pregnant women AND ALL OTHER ENROLLEES OF MANAGED CARE
ORGANIZATIONS WHO REQUIRE THESE SERVICES,

(vii) Educate Program—recipients ENROLLEES on health care
prevention and good health habits;

(viii) Assure necessary provider capacity in all geographic areas under
contract;

(IX) SUBJECT TO PARAGRAPH (9) OF THIS SUBSECTION, PROVIDE
DIAGNOSTIC, EMERGENCY, PREVENTIVE, AND RESTORATIVE DENTAL SERVICES
FOR CHILDREN AND FOR ADULTS;

(ix) (X) (IX) Be accountable AND HOLD ITS SUBCONTRACTORS
ACCOUNTABLE for standards established by the Department and, upon failure to meet
those standards, be subject to a penalty up to and including revocation of its Medicaid
managed care contract ONE OR MORE OF THE FOLLOWING PENALTIES:

1.       FINES;

2.       SUSPENSION OF FURTHER ENROLLMENTS;

3.       WITHHOLDING OF ALL OR PART OF THE CAPITATION
PAYMENT;

4.       TERMINATION OF THE CONTRACT;

5.       DISQUALIFICATION FROM FUTURE PARTICIPATION IN
THE PROGRAM; AND

6.       ANY OTHER PENALTIES THAT MAY BE IMPOSED BY THE
DEPARTMENT; and

(x) (XI) Subject to applicable federal and State law, include
incentives for Program recipients ENROLLEES to comply with provisions of the managed
care [plan] ORGANIZATION[, and disincentives for failing to comply with provisions of
the managed care plan] .,

(XII) PROVIDE OR ARRANGE TO PROVIDE THOSE PRIMARY MENTAL
HEALTH SERVICES TRADITIONALLY DELIVERED BY PRIMARY CARE PROVIDERS;

(XIII) PROVIDE EXCEPTIONAL NEEDS CARE COORDINATORS TO
ASSIST INDIVIDUALS IN SPECIAL NEEDS POPULATIONS, AS DEFINED BY THE
DEPARTMENT THE DEPARTMENT SHALL ADOPT REGULATIONS THAT ASSURE THAT
MANAGED CARE ORGANIZATIONS EMPLOY APPROPRIATE PERSONNEL TO:

(1) ASSURE THAT INDIVIDUALS WITH SPECIAL NEEDS OBTAIN
NEEDED SERVICES; AND

(2) COORDINATE THOSE SERVICES

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