20. CULTURAL COMPETENCY
45
21. MEDICAL RECORDS
45
22. ADVANCE DIRECTIVES
46
23. QUALITYMANAGEMENT (QM)
47
24. MEDICAL MANAGEMENT (MM)
51
25. ADMINISTRATIVE PERFORMANCE STANDARDS
52
26. GRIEVANCE SYSTEM
54
27. NETWORK DEVELOPMENT
54
28. PROVIDER AFFILIATION TRANSMISSION
56
29. NETWORK MANAGEMENT
57
30. PRIMARY CARE PROVIDER STANDARDS
58
31. MATERNITY CARE PROVIDER STANDARDS
59
32. REFERRALMANAGEMENT PROCEDURES AND STANDARDS
61
33. APPOINTMENT STANDARDS
61
34. FEDERALLY QUALIFIED HEALTH CENTERS AND RURAL HEALTH CLINICS
63
35. PROVIDER MANUAL
63
36. PROVIDER REGISTRATION
63
37. SUBCONTRACTS
63
38. CLAIMS PAYMENT/HEALTH INFORMATION SYSTEM
66
39. SPECIALTY CONTRACTS
69
40. HOSPITAL SUBCONTRACTING AND REIMBURSEMENT
71
41. RESPONSIBILITY FOR NURSING FACILITY REIMBURSEMENT
71
42. PHYSICIAN INCENTIVES/PAY FOR PERFORMANCE
72
43. MANAGEMENT SERVICES AGREEMENT AND COST ALLOCATION PLAN
73
44. RESERVED
73
45. RESERVED
73
46. PERFORMANCE BOND OR BOND SUBSTITUTE
73
47. AMOUNT OF PERFORMANCE BOND
74
48. ACCUMULATED FUND DEFICIT
74
49. ADVANCES, DISTRIBUTIONS, LOANS AND INVESTMENTS
75
50. FINANCIAL VIABILITY STANDARDS
75
51. SEPARATE INCORPORATION
77
52. MERGER, REORGANIZATION AND CHANGE OF OWNERSHIP
77
53. COMPENSATION
77
54. PAYMENTS TO CONTRACTORS
79
55. CAPITATION ADJUSTMENTS
79
56. RESERVED
80
57. REINSURANCE
80
58. COORDINATION OF BENEFITS
85
59. COPAYMENTS
88
60. MEDICARE SERVICES AND COST SHARING
89
61. MARKETING
89
62. CORPORATE COMPLIANCE
89
63. RECORDS RETENTION
91
64. DATA EXCHANGE REQUIREMENTS
91
65. ENCOUNTER DATA REPORTING
92
66. ENROLLMENT AND CAPITATION TRANSACTION UPDATES
94
67. PERIODIC REPORT REQUIREMENTS
95
68. REQUESTS FOR INFORMATION
95
69. DISSEMINATION OF INFORMATION
95
70. OPERATIONAL AND FINANCIAL READINESS REVIEWS
95
71. OPERATIONAL AND FINANCIAL REVIEWS
96
72. SANCTIONS
96
73. BUSINESS CONTINUITY AND RECOVERY PLAN
97
74. TECHNOLOGICAL ADVANCEMENT
99
75. PENDING LEGISLATIVE / OTHER ISSUES
100
76. SUPPORT OF ARIZONA BASED TRANSLATIONAL AND CLINICAL RESEARCH
101
77. RESERVED
101
78. RESERVED
101
SECTION E: CONTRACT CLAUSES
102
1) APPLICABLE LAW
102
2) AUTHORITY
102
3) ORDER OF PRECEDENCE
102
4) CONTRACT INTERPRETATION AND AMENDMENT
102
5) SEVERABILITY
102
6) RELATIONSHIP OF PARTIES
102
7) ASSIGNMENT AND DELEGATION
102
8) INDEMNIFICATION
103
9) INDEMNIFICATION -- PATENT AND COPYRIGHT
103
10) COMPLIANCE WITH APPLICABLE LAWS, RULES AND REGULATIONS
103
11) ADVERTISING AND PROMOTION OF CONTRACT
103
12) PROPERTY OF THE STATE
103
13) THIRD PARTY ANTITRUST VIOLATIONS
104
14) RIGHT TO ASSURANCE
104
15) TERMINATION FOR CONFLICT OF INTEREST
104
16) GRATUITIES
104
17) SUSPENSION OR DEBARMENT
104
18) TERMINATION FOR CONVENIENCE
104
19) TEMPORARY MANAGEMENT/OPERATION OF A CONTRACTOR AND TERMINATION
105
20) TERMINATION - AVAILABILITY OF FUNDS
106
21) RIGHT OF OFFSET
106
22) NON-EXCLUSIVE REMEDIES
106
23) NON-DISCRIMINATION
106
24) EFFECTIVE DATE
106
25) INSURANCE
106
26) DISPUTES
107
27) RIGHT TO INSPECT PLANT OR PLACE OF BUSINESS
107
28) INCORPORATION BY REFERENCE
107
29) COVENANT AGAINST CONTINGENT FEES
107
30) CHANGES
108
31) TYPE OF CONTRACT
108
32) AMERICANS WITH DISABILITIES ACT
108
33) WARRANTY OF SERVICES
108
34) NO GUARANTEED QUANTITIES
108
35) CONFLICT OF INTEREST
108
36) CONFIDENTIALITY AND DISCLOSURE OF CONFIDENTIAL INFORMATION
108
37) COOPERATION WITH OTHER CONTRACTORS
109
38)