Common use of Quality Management and Monitoring Clause in Contracts

Quality Management and Monitoring. As a model conducted under the authority of Section 1115A of the Social Security Act, the Demonstration and independent evaluation will include and assess quality measures designed to ensure Beneficiaries are receiving high quality care. In addition, CMS and the State shall continue to conduct comprehensive performance and quality monitoring processes.‌ During the Demonstration, and unless otherwise identified in this MOU, MSHO Plans will be subject to the prevailing Medicare Advantage performance measurement and Part D requirements, public reporting systems and required quality initiatives, including Chronic Care Improvement Programs (CCIP), Quality Improvement Projects (QIP), and Medicaid External Quality Review Organization (EQRO) activities as well as all current Medicaid measurement and reporting systems. In addition, the State will test new quality measurement approaches that may include new measures, revisions to existing surveys, translating surveys into different languages to increase Enrollee response rates, and/or revised data sharing arrangements and analysis. New measures will be tested in conjunction with national consensus organizations and CMS. The measures are discussed further in Appendix 4.‌

Quality Management and Monitoring. As a model conducted under the authority of Section 1115A of the Social Security Act, the Demonstration and independent evaluation will include and assess quality measures designed to ensure Beneficiaries are receiving high quality care. In addition, CMS and the State shall continue to conduct comprehensive performance and quality monitoring processes.‌ processes. During the Demonstration, and unless otherwise identified in this MOU, MSHO Plans will be subject to the prevailing Medicare Advantage performance measurement and Part D requirements, public reporting systems and required quality initiatives, including Chronic Care Improvement Programs (CCIP), Quality Improvement Projects (QIP), and Medicaid External Quality Review Organization (EQRO) activities as well as all current Medicaid measurement and reporting systems. In addition, the State will test new quality measurement approaches that may include new measures, revisions to existing surveys, translating surveys into different languages to increase Enrollee response rates, and/or revised data sharing arrangements and analysis. New measures will be tested in conjunction with national consensus organizations and CMS. The measures are discussed further in Appendix 4.‌4.