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

Standard XII: Administration and Management
CC-XVI.Q
CONTRACT
SECTION
72. Termination
Hearings
CC-XVI.Q.1
73. Receipt of Final
Notice of
Termination
AGENCY FOR HEALTHCARE ADMINISTRATION
MANAGED CARE ORGANIZATIONS
Compliance Monitoring Tool with Specific Contract Standards
CONTRACT REQUIREMENT COMPLIANT SCORING
termination, the extent to which performance of
work under the Contract is terminated, and the
date on which such termination becomes
effective.
The Agency provides the health plan with an
opportunity for a hearing prior to termination for
cause.
This does not preclude the Agency from
terminating without cause.
Upon receipt of final notice of termination, on
the date and to the extent specified in the notice
of termination, the health plan:
a. Continues work under the Contract until the
termination date unless otherwise required by
the Agency.
b. Ceases enrollment of new enrollees under the
Contract.
c. Terminates all community outreach activities
and subcontracts relating to community
outreach.
d. Assigns to the state those subcontracts as
directed by the Agency's contracting officer
including all the rights, title and interest of
the health plan for performance of those
subcontracts.
e. In the event the Agency has terminated this
Contract in one or more Agency areas of the
state, completes the performance of this
Contract in all other areas in which the health
plan’s Contract was not terminated.
Yes
No
N/A
a. Yes
No
N/A
b. Yes
No
N/A
c. Yes
No
N/A
d.Yes
No
N/A
e. Yes
No
N/A
f. Yes
No
N/A
g.Yes
No
N/A
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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