Quality Management and Improvement Program Clause Samples

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Quality Management and Improvement Program. The Contractor’s Medical Director shall be responsible for the coordination and implementation of the Quality Management and Improvement Program. The program shall have objectives that are measurable, realistic and supported by consensus among the Contractor’s medical and quality improvement staff. Through the Quality Management and Improvement Program, the Contractor shall have ongoing comprehensive quality assessment and performance improvement activities aimed at improving the delivery of health care services to members. As a key component of its Quality Management and Improvement Program, the Contractor shall develop incentive programs for both providers and members, with the ultimate goal of encouraging appropriate utilization of health care resources and improving health outcomes of Hoosier Healthwise members. The Contractor shall establish different provider and member incentives for its Hoosier Healthwise population.
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Quality Management and Improvement Program. Provider will participate in, cooperate with and comply with all quality management and improvement program requirements and all decisions rendered by United in connection with the quality management and improvement program. Provider also will provide, within ten (10) days of receipt of written or electronic notice, all medical records, review data and other information as may be required or requested under the quality management and improvement program. Records required or requested by United under the quality management and improvement program for VA CCN are not subject to reimbursement by United.
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Quality Management and Improvement Program. The MCO’s Medical Director must be responsible for the coordination and implementation of the Quality Management and Improvement Program. The program must have objectives that are measurable, realistic and supported by consensus among the MCO’s medical and quality improvement staff. Through the Quality Management Program, the MCO must have ongoing comprehensive quality assessment and performance improvement activities aimed at improving its internal functioning, improve the delivery of health care services to members and improve health outcomes of its members. The MCO must meet the requirements of 42 CFR 438 subpart D and the National Committee for Quality Assurance (NCQA), including but not limited to the requirements listed below, in developing its quality management program. In doing so, it shall include an assessment of quality and appropriateness of care provided to member with special needs, complete performance improvement projects in a reasonable time so as to allow information about the success of performance improvement projects and to produce new information on quality of care every year. The MCO’s Quality Management and Improvement Program must: • Include developing and maintaining an annual quality improvement plan which sets goals, establishes specific objectives, identifies the strategies and activities to undertake, monitors results and assesses progress toward the goals. • Have written policies and procedures for quality improvement. Policies and procedures must include methods, timelines and individuals responsible for completing each task • Incorporate an internal system for monitoring services, including clinically appropriate data collection and management for clinical studies, internal quality improvement activities, assessment of special needs population and other quality improvement activities requested by OMPP • Participate appropriately in clinical studies, such as the Health Plan Employer Data and Information Set® (HEDIS®) measures and in other studies requested by OMPP, such as assessment of the quality and appropriateness of care provided to members, in accordance with EPSDT/Health Watch requirements • Collect measurement indicator data related to areas of clinical priority and quality of care. The Hoosier Healthwise Clinical Studies and the Quality Improvement Committees will establish areas of clinical priority and indicators of care. These areas may vary from one year to the next, and they will reflect the needs of the Hoosi...
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Quality Management and Improvement Program. Provider agrees to comply with the quality management and improvement program of each Payer Plan and to consult with HPN and Payer regarding such activities.
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Quality Management and Improvement Program. Provider agrees to comply with the quality management and improvement program of each SelectCare and to consult with SelectCare regarding such activities.
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Quality Management and Improvement Program implementation of the Quality Management and Improvement Program. The program shall have objectives that are measurable, realistic and supported by consensus among the
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Quality Management and Improvement Program a. The Contractor shall institute processes to assess, plan, implement and evaluate the quality of care provided to behavioral health recipients. The Contractor shall have a quality management and improvement program that fulfills all applicable requirements on Quality Management contained within the ADHS/DBHS Policies and Procedures Manual and the ADHS/DBHS Provider Manual. AHCCCS will monitor all AHCCCS quality management requirements outlined in AHCCCS Medical Policy Manual (AMPM), Chapter 900, for all direct billing services provided by the Contractor under the AHCCCS-Apache Behavioral Health Services Contract. The Quality Management Program shall require monitoring, reporting, and performance improvement activities, as agreed upon in collaboration with ▇▇▇▇ and ▇▇▇▇▇▇. b. The Contractor shall have a sufficient number of qualified personnel to fulfill all quality management functions. The Contractor shall ensure that all activities within quality management are for the purpose of improving quality of care and meeting requirements set forth in this Agreement, as well as agreement with AHCCCS and IHS. The Contractor shall conduct provider monitoring activities and avoid unnecessary review and monitoring that will not assist in improving the quality of care or meeting the requirements of this Agreement. c. The Contractor shall ensure active participation in appropriate data collection and analysis with approval of the White Mountain Apache Tribal Council. The Contractor shall actively participate in the monitoring and tracking of quality improvement findings and shall take such actions as determined necessary to improve the quality of care provided to behavioral health recipients. d. The Contractor shall inform ADHS within one (1) day of its knowledge of significant incidents/accidents involving behavioral health recipients and provide a summary of findings and corrective actions required, if any, following investigation of the incident/accident. e. ADHS intends to enhance its quality management system in order to more effectively monitor the process of improving services under the JK Settlement Agreement. As these changes are implemented, the Contractor shall conform its quality management systems to be consistent with ADHS quality management systems including monitoring and performance improvement activities.
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Quality Management and Improvement Program. Provider agrees to comply with the quality improvement and compliance program of PMC and to consult with PMC regarding such activities.
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Quality Management and Improvement Program. The quality of Covered Services rendered by Provider to Enrolled Eligible Veteran is subject to the quality management and improvement program described in the VA CCN Requirements. Provider will participate in, cooperate with and comply with all quality management and improvement program requirements and all decisions rendered by OPSS in connection with the quality management and improvement program. Provider also will provide, within ten (10) days of receipt of written notice, all medical records, review data and other information as may be required or requested under the quality management and improvement program.
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Related to Quality Management and Improvement Program

  • Quality Management Grantee will: 1. comply with quality management requirements as directed by the System Agency. 2. develop and implement a Quality Management Plan (QMP) that conforms with 25 TAC § 448.504 and make the QMP available to System Agency upon request. The QMP must be developed no later than the end of the first quarter of the Contract term. 3. update and revise the QMP each biennium or sooner, if necessary. ▇▇▇▇▇▇▇’s governing body will review and approve the initial QMP, within the first quarter of the Contract term, and each updated and revised QMP thereafter. The QMP must describe ▇▇▇▇▇▇▇’s methods to measure, assess, and improve - i. Implementation of evidence-based practices, programs and research-based approaches to service delivery; ii. Client/participant satisfaction with the services provided by ▇▇▇▇▇▇▇; iii. Service capacity and access to services; iv. Client/participant continuum of care; and v. Accuracy of data reported to the state. 4. participate in continuous quality improvement (CQI) activities as defined and scheduled by the state including, but not limited to data verification, performing self-reviews; submitting self-review results and supporting documentation for the state’s desk reviews; and participating in the state’s onsite or desk reviews. 5. submit plan of improvement or corrective action plan and supporting documentation as requested by System Agency. 6. participate in and actively pursue CQI activities that support performance and outcomes improvement. 7. respond to consultation recommendations by System Agency, which may include, but are not limited to the following: i. Staff training; ii. Self-monitoring activities guided by System Agency, including use of quality management tools to self-identify compliance issues; and iii. Monitoring of performance reports in the System Agency electronic clinical management system.

  • Quality Management System Supplier hereby undertakes, warrants and confirms, and will ensue same for its subcontractors, to remain certified in accordance with ISO 9001 standard or equivalent. At any time during the term of this Agreement, the Supplier shall, if so instructed by ISR, provide evidence of such certifications. In any event, Supplier must notify ISR, in writing, in the event said certification is suspended and/or canceled and/or not continued.

  • Quality Improvement The Parties must develop QI activities specifically for the oversight of the requirements of this MOU, including, without limitation, any applicable performance measures and QI initiatives, including those to prevent duplication of services, as well as reports that track referrals, Member engagement, and service utilization. Such QI activities must include processes to monitor the extent to which Members are able to access mental health services across SMHS and NSMHS, and Covered Service utilization. The Parties must document these QI activities in policies and procedures.

  • PROFESSIONAL DEVELOPMENT AND EDUCATIONAL IMPROVEMENT A. Both the Board and the Association encourage teachers to seek professional improvement. In order to assist teachers in extending and improving their skills the following plan will be implemented. B. All Teachers will be encouraged to earn a Masters degree or coursework toward additional certification that is in the field of education and within a teacher's discipline, or in an area that is beneficial to the school. C. The Board will pay teacher's expenses for undergraduate and/or graduate credits, specialty and additional endorsements under the following conditions. 1. In allocating budgeted funds priority will be given to the teachers in a “masters” program and those teachers who need to complete coursework for certification. 2. All courses must be approved, in advance, by the Superintendent. Courses for recertification purposes must be approved in advance by the certification committee and the superintendent. The teacher shall receive a written reply from the Superintendent within ten (10) days of application for course approval (See Appendix D). 3. Each teacher will be eligible for up to six (6) semester hours of credit or, if enrolled in a matriculated, organized program, 12 semester hours of credit for undergraduate will be paid if part of a graduate program or graduate courses per contract year. The Superintendent reserves the right to request intent to take courses prior to final budget preparation. Failure to communicate such intent at the time of the Superintendent’s request may jeopardize course reimbursement due to a lack of funding. 4. The administration will pay in advance the cost of the course. Presentation of evidence of satisfactory completion of the course (A grade of B or better) is the responsibility of the teacher. In the event the course is not completed or not completed satisfactorily, the teacher will refund the payment received in advance and in accordance with Appendix D – attached. 5. Teachers who resign shall not be eligible for reimbursement after the date of resignation Teachers who have been reimbursed for any course work toward securing a masters within the last two (2) years of employment shall be required to continue their service to RSU # 78 for an additional two (2) years (twenty-four months) or will be required to reimburse the district the cost associated with Masters courses taken prior to departing, Such reimbursement to the district shall be remitted via payroll deductions as arranged between the District and employee, unless the failure to continue employment is due to illness, disability, death, or reduction of position. 6. Reimbursement will only be for tuition and fees. It will not include reimbursement for mileage, books and other expenses unless the teacher is required to take the course by the administration.

  • School Improvement The parties do hereby mutually agree that the school improvement process currently in effect will continue. Any plan developed by the committees shall not be in conflict with the master agreement or board policy.