Regional Generic Provider Agreement - Ohio Department of Job and ...
Regional Generic Provider Agreement - Ohio Department of Job and ...
Regional Generic Provider Agreement - Ohio Department of Job and ...
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Appendix M<br />
Covered Families <strong>and</strong> Children (CFC) population<br />
Page 19<br />
appropriate penalty to the area <strong>of</strong> deficiency identified with any individual measure, notwithst<strong>and</strong>ing<br />
the penalties specified in this Appendix.<br />
5.a. Report Periods<br />
Unless otherwise noted, the most recent report or study finalized prior to the end <strong>of</strong> the contract<br />
period will be used in determining the MCP’s performance level for that contract period.<br />
5.b. Monetary Sanctions<br />
Penalties for noncompliance with individual st<strong>and</strong>ards in this appendix will be imposed as the results<br />
are finalized. Penalties for noncompliance with individual st<strong>and</strong>ards for each period <strong>of</strong> compliance,<br />
as determined in this appendix, will not exceed $250,000.<br />
Refundable monetary sanctions will be based on the capitation payment in the month <strong>of</strong> the cited<br />
deficiency <strong>and</strong> due within 30 days <strong>of</strong> notification by ODJFS to the MCP <strong>of</strong> the amount. Any monies<br />
collected through the imposition <strong>of</strong> such a sanction would be returned to the MCP (minus any<br />
applicable collection fees owed to the Attorney General’s Office, if the MCP has been delinquent in<br />
submitting payment) after they have demonstrated improved performance in accordance with this<br />
appendix. If an MCP does not comply within two years <strong>of</strong> the date <strong>of</strong> notification <strong>of</strong><br />
noncompliance, then the monies will not be refunded.<br />
5.c. Combined Remedies<br />
If ODJFS determines that one systemic problem is responsible for multiple deficiencies, ODJFS may<br />
impose a combined remedy which will address all areas <strong>of</strong> deficient performance. The total fines<br />
assessed in any one month will not exceed 15% <strong>of</strong> the MCP’s monthly capitation.<br />
5.d. Enrollment Freezes<br />
MCPs found to have a pattern <strong>of</strong> repeated or ongoing noncompliance may be subject to an<br />
enrollment freeze.<br />
5.e. Reconsideration<br />
Requests for reconsideration <strong>of</strong> monetary sanctions <strong>and</strong> enrollment freezes may be submitted as<br />
provided in Appendix N, Compliance Assessment System.<br />
5.f. Contract Termination, Nonrenewals or Denials<br />
Upon termination, nonrenewal or denial <strong>of</strong> an MCP contract, all monetary sanctions collected under<br />
this appendix will be retained by ODJFS. The at-risk amount paid to the MCP under the current<br />
provider agreement will be returned to ODJFS in accordance with Appendix P, Terminations, <strong>of</strong><br />
the provider agreement.