Letter to CMS - Medicaid Managed Care Policies - Agency for ...

Standard XII: Administration and Management
CONTRACT
SECTION
Minority
Participation
Report
CC-XVI.O.3
44. Emergency
Management
Plan
CC-XVI.BB
45. Notification of
Legal Actions
CC-XVI.K
AGENCY FOR HEALTHCARE ADMINISTRATION
MANAGED CARE ORGANIZATIONS
Compliance Monitoring Tool with Specific Contract Standards
CONTRACT REQUIREMENT COMPLIANT SCORING
annually, in writing, to HSD by September 1 of
each Contract year.
Annually by May 31 of each Contract year, the
health plan submits to BMHC for approval an
emergency management plan specifying what
actions the health plan conducts to ensure the
ongoing provision of health services in a disaster
or man-made emergency including, but not
limited to, localized acts of nature, accidents, and
technological and/or attack-related emergencies.
If the emergency management plan is unchanged
from the previous year, the health plan submits a
certification to BMHC that the prior year’s plan
is still in place.
The health plan gives HSD, by certified mail,
immediate written notification (no later than
thirty [30] calendar days after service of process)
of any action or suit filed or of any claim made
against the health plan by any subcontractor,
vendor, or other party that results in litigation
related to this Contract for disputes or damages
exceeding the amount of $50,000.
In addition, the health plan immediately advises
HSD of the insolvency of a subcontractor or of
the filing of a petition in bankruptcy by or
against a principal subcontractor.
Yes
No
Yes
No
Met
Partially Met
Not Met
Met
Partially Met
Not Met
DOCUMENTS
REVIEWED
FINDINGS
State of Florida Compliance Monitoring_Standard_XII_F2_07_11
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