The evaluation process performed by the Administration shall be determined taking into consideration the regional area for which direct contracting is requested, the number of persons for whom the rendering of services is requested, physical facilities, financial capacity, capital for the financing of services, and the ability to provide risk management services. The following elements shall be considered in the evaluation process:(a) Capacity, efficiency and pertinence of the information system used to register appointments and to process claims electronically.(b) Availability and efficiency of cost control programs, including the review of use and quality control programs.(c) Administrative and financial capacity of the proponent organization, including the network of coordinated care providers.(d) Availability of preventive medicine programs.(e) Availability of primary physicians and specialists.(f) Availability of emergency rooms.(g) Availability of beneficiary complaints and grievances programs, and compliance plan pursuant to applicable local and federal statutes. History —Sept. 7, 1993, No. 72, added as Art. IX, § 3 on Dec. 29, 2003, No. 334, § 2, eff. 30 days after Dec. ievances programs, and compliance plan pursuant to applicable local and federal statutes. History —Sept. 7, 1993, No. 72, added as Art. IX, § 3 on Dec. 29, 2003, No. 334, § 2, eff. 30 days after Dec. 29, 2003.
Puerto Rico Legal Code