Agency Annual Medical Record Audit Sample Clauses

Agency Annual Medical Record Audit a. The Health Plan shall furnish specific data requested in order for the Agency to conduct the medical record audit. b. If the medical record audit indicates that quality of care is not acceptable within the terms of this Contract, the Agency shall sanction the Health Plan, in accordance with the provisions of Attachment II, Section XIV, Sanctions, and may immediately terminate all enrollment activities and mandatory assignments, until the Health Plan attains an acceptable level of quality of care as determined by the Agency. When considering whether to impose a limitation on enrollment activities or mandatory assignment, the Agency may take into account the Health Plan’s cumulative performance on all QI activities.
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Agency Annual Medical Record Audit a. The Health Plan shall furnish specific data requested in order for the Agency to conduct the medical record audit. b. If the medical record audit indicates that quality of care is not acceptable within the terms of this Contract, the Agency shall sanction the Health Plan, in accordance with the provisions of Attachment II, Section XIV, Sanctions, and may immediately WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract terminate all enrollment activities and mandatory assignments, until the Health Plan attains an acceptable level of quality of care as determined by the Agency. When considering whether to impose a limitation on enrollment activities or mandatory assignment, the Agency may take into account the Health Plan’s cumulative performance on all QI activities.
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