Termination, Revocation and Sanctions. In addition to Health Plan’s and Subcontractor’s termination rights under the Agreement, Health Plan and Subcontractor may terminate, rescind or cancel the Agreement in the event Provider violates any applicable HSD or Collaborative requirements or State or federal statutes, rules or regulations. Health Plan and Subcontractor also have the right to revoke any functions or activities delegated to Provider or impose other sanctions consistent with the Centennial Care Contract if in Health Plan’s and/or Subcontractor’s reasonable judgment Provider’s performance under the Agreement is inadequate. Health Plan and Subcontractor shall also have the right to suspend, deny, refuse to renew or terminate Provider in accordance with the terms of the Centennial Care Contract and applicable law and regulation. Additionally, any program violations arising out of performance of the Agreement are subject to administrative enforcement by the Health and Human Services Commission Office of Inspector General (OIG). Health Plan shall notify HSD within 5 business days, via e-mail, when a formal written action is taken by Health against a provider. Such action being defined for purposes of this provision as: (i) denial of credentialing or enrollment, or contract termination, when the denial or termination is “for cause”, as such term is defined in the provider’s agreement with Health Plan; or (ii) due to concerns other than fraud, such as integrity or quality.
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Sources: New Mexico Centennial Care Regulatory Requirements Appendix, New Mexico Centennial Care Regulatory Requirements Appendix