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

Standard XII: Administration and Management
CONTRACT
SECTION
50. Definition of
Ownership
Requiring
Disclosure:
Part II
CC-XVI.V.2
51. Definition of
Ownership
Requiring
Disclosure: Part
III
CC-XVI.V.2
52. Management
Disclosure
AGENCY FOR HEALTHCARE ADMINISTRATION
MANAGED CARE ORGANIZATIONS
Compliance Monitoring Tool with Specific Contract Standards
CONTRACT REQUIREMENT COMPLIANT SCORING
The following definitions apply to ownership
disclosure: The percentage of direct ownership or
control is calculated by multiplying the percent
of interest that a person owns by the percent of
the health plan’s assets used to secure the
obligation.
Thus, if a person owns ten percent (10%) of a
note secured by sixty percent (60%) of the health
plan’s assets, the person owns six percent (6%)
of the health plan.
The following definitions apply to ownership
disclosure:
The percent of indirect ownership or control is
calculated by multiplying the percentage of
ownership in each organization.
Thus, if a person owns ten percent (10%) of the
stock in a corporation, which owns eighty
percent (80%) of the health plan’s stock, the
person owns eight percent (8%) of the health
plan.
The following definitions apply to management
disclosure:
a. Changes in management are defined as any
change in the management control of the
health plan.
b. Changes in the board of directors or officers
of the health plan, medical director, chief
executive officer, administrator, and chief
Yes
No
Yes
No
a. Yes
No
b. Yes
No
c. Yes
No
Met
Partially Met
Not Met
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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