Quality of Care

(a)The Administrator, subject to the Administrative Adjudication Law, shall develop by rule and regulation a standard for Providers to use in monitoring the quality of health care received by members. Each Provider shall adopt and use such standard.

(b)The Administrator shall periodically determine whether each Provider has properly adopted and implemented the quality of health care monitoring standard.

(1)If the Administrator determines that a Provider has not done so, the Administrator shall undertake additional special efforts to monitor and assess the quality of health care provided by that Provider for as long as the Administrator deems necessary.

(2)The Administrator shall determine the cost incurred in undertaking such special efforts and shall deduct that amount each month from any payment owed to that Provider for as long as the special efforts continue.