| | |
E.__When appropriate, to implement reimbursement schedules | | based upon the federal resource-based, relative-value scale, | | augmented as necessary to meet the needs of the plan; and |
|
| | | F.__To fulfill all other duties delegated to it pursuant to | | its contract with the authority. |
|
| | | 2.__Audit.__For each year of the contract with the authority, | | the administrator shall prepare a report on the operations of the | | administrator, including an annual internal and independent audit | | and an accounting of all revenues received and disbursed.__The | | administrator shall submit the report to the authority, the | | Governor, the joint standing committee of the Legislature having | | jurisdiction over insurance matters and the State Auditor no | | later than January 15th of each year. |
|
| | | 3.__Administrative costs.__The administrator's administrative | | budget is a matter of contract negotiated by the authority and | | the administrator. |
|
| | | §9808.__Reimbursement for participating providers |
|
| | | In accordance with this section, the administrator shall | | impose standards for participation by providers and negotiate | | with providers to establish reimbursement levels for services | | provided under the plan. |
|
| | | 1.__Goals and strategies.__Based on the state health resource | | plan, the global budget and the cost containment and quality | | assurance goals adopted by the authority, and subject to the | | board's advice and approval, the administrator shall: |
|
| | | A.__Establish sector-wide budgets for appropriate categories | | of providers; |
|
| | | B.__Develop reimbursement strategies to promote desirable | | utilization and practice patterns; |
|
| | | C.__Develop reimbursement strategies to promote access for | | underserved populations; |
|
| | | D.__Develop incentive programs to promote desirable capital | | expenditures; and |
|
| | | E.__Establish standards of quality that must be met by | | providers wishing to participate in the plan. |
|
|