Clinical Practice Guidelines. The CONTRACTOR shall utilize evidence-based clinical practice guidelines in its disease management programs and shall measure performance against at least two (2) important aspects of each of the guidelines annually as required in Section 2.8. The guidelines shall be reviewed and revised at least every two (2) years or whenever the guidelines change. 27. The renumbered Section 2.15.6.1 shall be amended by adding new text and shall read as follows: 2.15.6.1 Annually, beginning with HEDIS 2010, the CONTRACTOR shall complete all HEDIS measures designated by NCQA as relevant to Medicaid. The only exclusion from the complete Medicaid HEDIS data set shall be dental measures. The HEDIS measure results shall be reported separately for each Grand Region in which the CONTRACTOR operates. The CONTRACTOR shall contract with an NCQA certified HEDIS auditor to validate the processes of the CONTRACTOR in accordance with NCQA requirements. Audited HEDIS results shall be submitted to TENNCARE, NCQA and TENNCARE’s EQRO annually by June 15 of each calendar year. 28. The renumbered Section 2.15.6.2 shall be amended by adding new text and shall read as follows:
Appears in 2 contracts
Sources: Contractor Risk Agreement, Contractor Risk Agreement