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(b) Be responsible for developing the MCO's annual written quality assurance description including areas and objectives, scope, specific activities, and methodologies for continuous tracking, provide review and focus on health outcomes;

(c) Be responsible for the MCO's utilization management and quality assurance committee, direct the development and implementation of the MCO's internal quality assurance plan and utilization management activities, and monitor the quality of care that MCO members receive;

(d) Oversee the development of clinical care standards and practice guidelines and protocols for the MCO;

(f) Assure that adequate staff and resources are available for the provision of proper medical care and health education to members;

(g) Specify clinical or health service areas to be monitored;

(h) Specify the use of quality indicators that are objective, measurable, and based on current knowledge and clinical experience for priority areas selected by DSS as well as for areas the MCO selects; current Health Plan Employer Data and Information Set standards must be used;

(i) Oversee the MCO's referral process for specialty and out-of-plan services; all denied services must be reviewed by a physician, physician assistant, or advanced nurse practitioner; the reason for the denial must be documented and logged; all denials must identify appeal rights of the member;

(j) Be involved in the MCO's recruiting and credentialing activities;

(k) Be involved in the MCO's process for prior authorization and denying services;

(l) Be involved in the MCO's process for ensuring the confidentiality of medical records and member information;

(m) Be involved in the MCO's process for ensuring the confidentiality of the appointments, treatments, and required State reporting of adolescent sexually transmitted diseases;

(n) Work with the special programs coordinator to assure that reports of disease and conditions are made to DSS in accordance with all