LD 1241
pg. 14
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LR 1344
Item 1

 
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.


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