Ch. 363
1997 LAWS OF MARYLAND
(ix) Be accountable and hold its subcontractors accountable for
standards established by the Department and, upon failure to meet those standards, be
subject to 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;
6. Any other penalties that may be imposed by the Department;
Subject to applicable federal and State law, include incentives for
enrollees to comply with provisions of the managed care organization;
(xi) Provide or arrange to provide primary mental health services;
(xii) Provide or arrange to provide all Medicaid covered services
required to comply with State statutes and regulations mandating health and mental
health services for children in State supervised care;
1. According to standards set by the Department; and
2. Locally, to the extent the services are available locally;
(xiii) Submit to the Department aggregate information from the quality
assurance program, including complaints and resolutions from the enrollee and provider
grievance systems, the enrollee hotline, and enrollee satisfaction surveys;
(xiv) Maintain as part of the enrollee's medical record the following
information:
1. The basic health risk assessment conducted on enrollment;
2. Any information the managed care organization receives that
results from an assessment of the enrollee conducted for the purpose of any early
intervention, evaluation, planning, or case management program;
3. information from the local deportment of social services
regarding any other service or benefit the enrollee receives, including assistance or
benefits under Article 88A of the Code; and
4. Any information the managed care organization receives
from a school based clinic, a core services agency; a local health department, or any other
person that has provided health services to the enrollee; and
(xv) Upon provision of information specified by the Department under
paragraph (19) of this subsection, pay school based clinics for services provided to the
managed care organization's enrollees.
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