Clinical and Preventive Management Programs Sample Clauses

Clinical and Preventive Management Programs. (CPMP) 1. The INSURER together with the HCO are responsible for providing all preventive services as described in the GHIP Basic Coverage, including, but not limited to: PAP Smears, Colorectal Screening, Mammograms, Prostrate Screening Antigen (PSA), Cholesterol Screening, Sigmoidoscopy as indicated by the medical guidelines provided by the Department of Health, and, the Early Prevention Screening and Diagnostic Tests (EPSDT) guidelines as required by the Federal Law and Regulations. 2. The INSURER must collaborate with the Secretaría Auxiliar de Promoción de la Salud of the Department of Health providing a copy of the quarterly Preventive Services Report as mentioned in the SRP Section. 3. The INSURER in coordination with the HCO will be responsible for developing and implementing the following clinical management programs: a. DISEASE MANAGEMENT PROGRAM — The INSURER must develop a Disease Management Program (DMP) following the Puerto Rico Department of Health protocols and guidelines, which must address standardization processes for major chronic diseases including, but not limited to: Asthma, Diabetes, Hypertension and Congestive Heart Failure. This program shall include identification (Identification Process established by the MCO’s and ADMINSTRTION Disease Management Committee), treatment protocols, guidelines and surveillance/monitoring. A provision of the outcomes will be send to the Puerto Rico Department of Health.
Sample 1

Related to Clinical and Preventive Management Programs

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