Sec. 540.0504. QUALITY-BASED ENROLLMENT INCENTIVE PROGRAM FOR MEDICAID MANAGED CARE ORGANIZATIONS. The commission shall create an incentive program that automatically enrolls in a Medicaid managed care plan a greater percentage of recipients who did not actively choose a plan, based on: (1) the quality of care provided through the Medicaid managed care organization offering the plan; (2) the organization's ability to efficiently and effectively provide services, considering the acuity of populations the organization primarily serves; and (3) the organization's performance with respect to exceeding or failing to achieve appropriate outcome and process measures the commission develops, including measures based on potentially preventable events.
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