Mediation Panel. The MCO may request the recommendation of a three (3) person mediation panel within five (5) business days of receiving notice of a remedy or sanction, or a notice of termination under section 5.2.2 or 5.2.3 from the STATE. The mediation panel shall meet, accept both written and oral argument as requested, and make its recommendation within fifteen (15) days of receiving the request for recommendation unless the parties mutually agree to a longer time period. The Commissioner shall resolve all disputes after taking into account the recommendations of the mediation panel and within three (3) business days after receiving the recommendation of the mediation panel. For non-CBP MCOs, the panel shall be composed of one designee of the Minnesota Council of Health Plans, one designee of the Commissioner of Human Services, and one designee of the Commissioner of Health. For CBP MCOs, the three-person mediation panel shall be composed of one designee of the president of the association of Minnesota counties, one designee of the commissioner of human services, and one person selected jointly by the designee of the commissioner of human services and the designee of the Association of Minnesota Counties. The State shall not require that contractual disputes between county-based purchasing entities and the State be mediated by a panel that includes a representative of the Minnesota Council of Health Plans. [Minnesota Statutes, §256B.69, subd. 3a(d) and (f)] After the hearing, the STATE must give the MCO written notice of the decision affirming or reversing the proposed termination of the Contract and, for an affirming decision, the effective date of termination. [42 CFR §438.710(b)(2)(ii)] 5.8 PENALTIES FOR ENCOUNTER DATA ERRORS. The STATE must ensure that enrollee encounter data is validated for accuracy and completeness under 42 CFR §438.242. In pursuit of this goal, the STATE will impose penalties upon the MCO for failure to timely correct encounter data errors as required under section 3.14.2.1 above. The notice and opportunity to cure requirements in section 5.4 are not applicable to encounter data quality errors and penalties assessed under this section.
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Mediation Panel. The MCO may request the recommendation of a three (3) person mediation panel within five (5) business days of receiving notice of a remedy or sanction, or a notice of termination under section 5.2.2 or 5.2.3 from the STATE. The mediation panel shall meet, accept both written and oral argument as requested, and make its recommendation within fifteen (15) days of receiving the request for recommendation unless the parties mutually agree to a longer time period. The Commissioner shall resolve all disputes after taking into account the recommendations of the mediation panel and within three (3) business days after receiving the recommendation of the mediation panel. For non-CBP MCOs, the panel shall be composed of one designee of the Minnesota Council of Health Plans, one designee of the Commissioner of Human Services, and one designee of the Commissioner of Health. For CBP MCOs, the three-person mediation panel shall be composed of one designee of the president of the association of Minnesota counties, one designee of the commissioner of human services, and one person selected jointly by the designee of the commissioner of human services and the designee of the Association of Minnesota Counties. The State shall not require that contractual disputes between county-based purchasing entities and the State be mediated by a panel that includes a representative of the Minnesota Council of Health Plans. [Minnesota Statutes, §256B.69, subd. 3a(d) and (f)] After the hearing, the STATE must give the MCO written notice of the decision affirming or reversing the proposed termination of the Contract and, for an affirming decision, the effective date of termination. [42 CFR §438.710(b)(2)(ii)] 5.8 PENALTIES FOR ENCOUNTER DATA ERRORS. The STATE must ensure that enrollee encounter data is validated for accuracy and completeness under 42 CFR §438.242. In pursuit of this goal, the STATE will impose penalties upon the MCO for failure to timely correct encounter data errors as required under section 3.14.2.1 above. The notice and opportunity to cure requirements in section 5.4 are not applicable to encounter data quality errors and penalties assessed under this section.ERRORS.
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Samples: mn.gov
Mediation Panel. The MCO may request the recommendation of a three (3) person mediation panel within five (5) business days of receiving notice of a remedy or sanction, or a notice of termination under section 5.2.2 or 5.2.3 from the STATE. The mediation panel shall meet, accept both written and oral argument as requested, and make its recommendation within fifteen (15) days of receiving the request for recommendation unless the parties mutually agree to a longer time period. The Commissioner shall resolve all disputes after taking into account the recommendations of the mediation panel and within three (3) business days after receiving the recommendation of the mediation panel. For non-CBP MCOs, the panel shall be composed of one designee of the Minnesota Council of Health Plans, one designee of the Commissioner of Human Services, and one designee of the Commissioner of Health. For CBP MCOs, the three-person mediation panel shall be composed of one designee of the president of the association of Minnesota counties, one designee of the commissioner of human services, and one person selected jointly by the designee of the commissioner of human services and the designee of the Association of Minnesota Counties. The State shall not require that contractual disputes between county-based purchasing entities and the State be mediated by a panel that includes a representative of the Minnesota Council of Health Plans. [Minnesota Statutes, §256B.69, subd. 3a(d) and (f)] f)] After the hearing, the STATE must give the MCO written notice of the decision affirming or reversing the proposed termination of the Contract and, for an affirming decision, the effective date of termination. [42 CFR §438.710(b)(2)(ii)] 5.8 5.9 PENALTIES FOR ENCOUNTER DATA ERRORS. The STATE must ensure that enrollee encounter data is validated for accuracy and completeness under 42 CFR §438.242. In pursuit of this goal, the STATE will impose penalties upon the MCO for failure to timely correct encounter data errors as required under section 3.14.2.1 above. The notice and opportunity to cure requirements in section 5.4 are not applicable to encounter data quality errors and penalties assessed under this section.ERRORS.
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Samples: mn.gov
