Okla. Stat. tit. 56, § 56-4002.4a
This is the official text of Okla. Stat. tit. 56, § 56-4002.4a, part of Oklahoma’s Stat. tit. 56, — part of the compiled statutory law of Oklahoma, published by the state as "Stat. tit. 56,." Browse the sections below, each linked to its official government source.
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Standard contract terms
Official statutory text
A. 1. The Oklahoma Health Care Authority shall develop
standard contract terms for contracted entities to include, but not
be limited to, all requirements stipulated by this act. The
Authority shall oversee and monitor performance of contracted
entities and shall enforce the terms of capitated contracts as
required by paragraph 2 of this subsection.
2. The Authority shall require each contracted entity to meet
all contractual and operational requirements as defined in the
requests for proposals issued pursuant to Section 3 of this act.
Such requirements shall include but not be limited to reimbursement
and capitation rates, insurance reserve requirements as specified by
the Insurance Department, acceptance of risk as defined by the
Authority, operational performance expectations including the
assessment of penalties, member marketing guidelines, other
applicable state and federal regulatory requirements, and all
requirements of this act including, but not limited to, the
requirements stipulated in this section.
B. The Authority shall develop methods to ensure program
integrity against provider fraud, waste, and abuse.
C. The Authority shall develop processes for providers and
Medicaid members to report violations by contracted entities of
applicable administrative rules, state laws, or federal laws.
standard contract terms for contracted entities to include, but not
be limited to, all requirements stipulated by this act. The
Authority shall oversee and monitor performance of contracted
entities and shall enforce the terms of capitated contracts as
required by paragraph 2 of this subsection.
2. The Authority shall require each contracted entity to meet
all contractual and operational requirements as defined in the
requests for proposals issued pursuant to Section 3 of this act.
Such requirements shall include but not be limited to reimbursement
and capitation rates, insurance reserve requirements as specified by
the Insurance Department, acceptance of risk as defined by the
Authority, operational performance expectations including the
assessment of penalties, member marketing guidelines, other
applicable state and federal regulatory requirements, and all
requirements of this act including, but not limited to, the
requirements stipulated in this section.
B. The Authority shall develop methods to ensure program
integrity against provider fraud, waste, and abuse.
C. The Authority shall develop processes for providers and
Medicaid members to report violations by contracted entities of
applicable administrative rules, state laws, or federal laws.
Status: in_force · Read it on the official government site
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