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(b) Periodic review of numerical data and/or narrative reports describing clinical and related information on health services and outcomes of health care for the enrolled population;

(c) On-site monitoring by DSS of QAP implementation to ensure compliance with all standards; such monitoring will take place at least once every six (6) months;

(d) Independent, external review of the quality of services furnished by each MCO, conducted by an entity under contract to DSS; such reviews will be conducted at least once each year; the MCO must agree to make available to DSS's external evaluator medical and other records (subject to confidentiality constraints) for review as requested;

(e) On-site visits and inspections of facilities;

(f) Staff and enrollee interviews;

(g) Review of appointment scheduling logs, emergency room logs, denial of services, and other areas that will indicate quality of care delivered to enrollees;

(h) Medical records reviews;

(i) All quality assurance procedures, reports, committee activities and recommendations, and corrective actions;

(j) Review of staff and provider qualifications;

(l) Review of requests for transfers between primary care providers within each MCO.

The MCO shall submit a corrective action plan to resolve any performance or quality of care deficiencies identified by the independent assessors and DSS as determined necessary by DSS.

Fraud and Abuse Protections

The MCO may not knowingly:

(a) have a person who has been debarred, suspended, or otherwise excluded from participating in procurement activities under the Federal Acquisition Regulation or from participating in non procurement activities under regulations issued pursuant to Executive Order 12549 or under guidelines implementing such order, as a Director, officer,