Termination Of Fiscal Employer Agent (Fea) Provider Agreements

In the event of termination of a provider agreement, the provider must: (7-1-25) 01. Continuation of Services. Ensure continuation of services to participants for the period in which a PMPM payment has been made, and submit the information, reports and records, including the Medicaid Billin g Report as specified in these rules. (7-1-25) 02. Advanced Notice. Provide to the Department a written notice ninety (90) days in advance and th e change notification must occur at the end of the next calendar quarter. (7-1-25) 03. Termination of Service. Provide to the participant a written notice ninety (90) days in advance . The change notification must occur at the end of the next calendar quarter. (7-1-25) 316. REMEDIES TO NONPERFORMANCE OF A FISCAL EMPLOYER AGENT (FEA) SERVICE PROVIDER. 01. Remedial Action. If any of the services do not comply with the performance metrics under thes e rules, the Department will consult with the provider and may, at its sole discretion, require any of the followin g remedial actions, taking into account the scope and severity of the noncompliance, compliance history, the integrit y of the program, and the potential risk to participants. (7-1-25) a. Require the provider to take corrective action to ensure that performance meets the performance metrics under Section 310 of these rules; (3-17-22) b. Reduce payment to reflect the reduced value of services received; (3-17-22) c. Require the provider to subcontract all or part of the service at no additional cost to the Department ; or (3-17-22) d. Terminate the provider agreement with notice. (3-17-22) 02. Direct Monetary Action. If any of the performance metrics under Section 310 of these rules ar e not met, the Department will enforce a fifty dollar ($50) a week penalty for each performance metric not met. Th e penalty will be captured prior to any payment from the Department to the provider. (3-17-22) 317. -- 999. (RESERVED)