Common use of External Quality Review Clause in Contracts

External Quality Review. The SCDHHS will perform periodic medical audits through contractual arrangements to determine if the Contractor furnished quality and accessible health care to Medicaid MCO program members in compliance with 42 CFR 438.358 (2006, as amended). SCDHHS willmay contract with an External Quality Review Organization (EQRO) to perform the periodic medical audits and external independent reviews. The MCO Policy and Procedure Guide and the Medicaid Managed Care External Review Services lists SCDHHS external quality assessment evaluation requirements.

External Quality Review. The SCDHHS will perform periodic medical audits through contractual arrangements to determine if the Contractor furnished quality and accessible health care to Medicaid MCO MHN program members in compliance with this contract and with the regulations pertaining to Primary Care Case Management programs found in 42 CFR 438.358 (2006, as amended)438. SCDHHS willmay will contract with an External Quality Review Organization (EQRO) to perform the periodic medical audits and external independent reviews. The MCO MHN Policy and Procedure Guide and the Medicaid Managed Care External Review Services lists SCDHHS external quality assessment evaluation requirements.

External Quality Review. The SCDHHS will perform periodic medical audits through contractual arrangements to determine if the Contractor furnished quality and accessible health care to Medicaid MCO program members in compliance with 42 CFR §438.358 (2006, as amended). SCDHHS willmay may contract with an External Quality Review Organization (EQRO) to perform the periodic medical audits and external independent reviews. The MCO Policy and Procedure Guide and the Medicaid Managed Care External Review Services lists SCDHHS external quality assessment evaluation requirements.