Common use of Department Oversight Clause in Contracts

Department Oversight. The CHIP-MCO and its Subcontractor(s) will make available to the Department upon request, data, clinical and other records and reports for review of quality of care, access and utilization issues including but not limited to activities related to External Quality Review, HEDIS®, Encounter Data validation, and other related activities. The CHIP-MCO must submit a plan, in accordance with the time frames established by the Department, to resolve any performance or quality of care deficiencies identified through ongoing monitoring activities and any independent assessments or evaluations requested by the Department. The CHIP-MCO must obtain advance written approval from the Department before releasing or sharing data, correspondence and/or improvements from the Department regarding the CHIP-MCO’s internal QM and UM programs with any of the other CHIP-MCOs or any external entity. The CHIP-MCO must obtain advance written approval from the Department before participating in or providing letters of support for QM or UM data studies and/or any data related external research projects related to CHIP with any entity.

Department Oversight. ‌ The CHIPCHC-MCO and its Subcontractor(s) subcontractor(s), including Network Providers, will make available to the Department upon request, data, clinical and other records and reports for review of quality of care, access and utilization issues including but not limited to activities related to External Quality Review, HEDIS®, Encounter Data validation, and other related activities. activities.‌ The CHIPCHC-MCO must submit a plan, in accordance with the time frames established by the Department, to resolve any performance or quality of care deficiencies identified through ongoing monitoring activities and any independent assessments or evaluations requested by the Department. Department.‌ The CHIPCHC-MCO must obtain advance written approval from the Department before releasing or sharing data, correspondence and/or improvements from the Department regarding the CHIPCHC-MCO’s internal QM and UM programs with any of the other CHIPCHC-MCOs or any external entity. entity.‌ The CHIPCHC-MCO must obtain advance written approval from the Department before participating in or providing letters of support for QM or UM data studies and/or any data related external research projects related to CHIP CHC with any entity.entity.‌