(1) Parties to an approved cooperative agreement, merger or consolidation must submit, in accordance with the provisions of this rule, progress reports that provide information to enable the department to evaluate the impact of the agreement or transaction on the availability, cost effectiveness, quality, and delivery of health care services and to determine whether the parties have complied with its terms and with the order of the department approving the agreement or transaction.

(a) The first progress report must be submitted on or before the first anniversary date of issuance of the certificate of public advantage. Thereafter, progress reports must be submitted at the end of the first quarter following the end of the parties' fiscal year. Only one report must be submitted each year unless the department requests in writing the submission of additional reports.

(b) Each progress report must contain the following information:

(i) a narrative providing a qualitative and quantitative assessment of progress in meeting the objectives identified as the basis for issuance of the certificate, including references to reports produced by the parties in the normal course of business that provide statistical support for each assessment;

(ii) if the objective(s) of the certificate of public advantage is (are) not being met or progress cannot be demonstrated, a narrative explanation as to why the objectives) is (are) not being met or there is no progress, together with the planned corrective actions and a proposed timetable for meeting the objective(s) of the certificate of public advantage; and

(iii) a narrative analysis of the benefits and disadvantages to health care consumers in Montana resulting from the implementation of the cooperative agreement, including benefits or disadvantages not previously identified.

(2) The department may require specific data relating to cost, access to health care, and quality of health care, or any other information it determines to be reasonably necessary to its inquiry. The department may conduct such audits of the books, records, and other documents pertaining to the agreement or transaction and of the operations under the agreement, merger, or consolidation as it determines to be reasonably necessary for the purpose of evaluating whether there has been compliance with the cooperative, merger or consolidation agreement approved by the department and whether any terms and conditions imposed by the department have been met, or to determine whether grounds exist for revocation under 50-4-609, MCA. The expense of the audit must be borne by the certificate holder(s) . The audit report shall be considered confidential and shall not be disclosed by the department unless confidentiality is waived by the parties or disclosure is required by order of a district court after notice to the certificate holder(s) .

(3) The department may solicit and consider public comment on any progress report required by this rule. The department may request additional oral or written information from the certificate holder(s) or from any other source. In assessing issues of health care costs, access, and quality, the department may receive information from any affected person, and may require a survey of patients, professionals, or other persons affected by the cooperative agreement, merger or consolidation. The costs of the survey must be borne by the certificate holder(s) .

(4) Any person may notify the department of conduct of the certificate holder(s) that is alleged to violate the cooperative, merger or consolidation agreement approved by the department or any terms and conditions imposed by the department. The notice must be in writing and include a statement of facts supporting the allegation of a violation. Upon receipt of such notice, the department may conduct any inquiry it finds appropriate. It is within the department's discretion to review any notice of violation, and a review may be conducted independently or in conjunction with the annual review provided by this rule.

(5) The department may request additional information from the certificate holder(s) at any time during the term of the cooperative agreement, merger or consolidation. The parties shall respond within 30 days to any additional requests for information requested by the department.

(6) If the department determines that the terms and conditions upon which a certificate has been issued are not being satisfied or that the agreement, merger, or consolidation is not meeting the objective(s) identified as the basis for the department's issuance of the certificate, it may impose additional terms and conditions determined necessary to effectuate the objectives of the certificate.