If federal funding stops or is significantly reduced, the administration shall cease processing applications and shall provide 30 days' notice to contractors that the program will terminate on the first day of the month following notice. Solvency requirements are to be included in a contract that may include withholding or forfeiture of payments and the administration may operate the contractor to insure uninterrupted care to members. Reserve funds may be retained from contracts, to be distributed to providers who meet performance standards. The director shall determine if a contractor has implemented standards to ensure quality of health care. A hospital may execute a subcontract with certain hospitals in certain counties.
Contracts awarded are exempt from the state procurement code.
The director may award a prepaid capitated contract with a health care services organization without bid in order to deliver services to enrolled members in a county. These contracts cannot extend beyond the next bid and contract award process. The director shall establish a grievance and appeal procedure. Provides for the reimbursement of a hospital's adjusted billed charges according to the prospective tiered per diem methodology and the procedures used for Title XIX reimbursement. Under this article, the administration is not required to use the attorney general' office as legal counsel.