Enrollee Data. Doctor agrees to comply with all requests by CMS, the Iowa Office of the Commissioner of Insurance (“OCI”), the Minnesota Department of Health (“MDH”), or any other state agency or department that regulates Health Plan Companies, a health plan company and/or CCMI for information that CMS, OCI or MDH requires, the health plan company or CCMI intends to release to purchasers of health care coverage, enrollees and other consumers, including without limitation, CCMI-specific and Doctor-specific quality, outcomes and patient satisfaction data. Doctor consents to the release by health plan companies and CCMI of such information and agrees not to attempt to prohibit or restrict the release of such information. Doctor agrees to provide CCMI, a health plan company, OCI, MDH, and CMS all information necessary for the reporting and submission obligations to OCI, MDH or CMS, including, but not limited to: all data necessary to characterize the context and purposes of each encounter between an Enrollee and Doctor; patterns of utilization of Doctor’s services; the availability, accessibility and acceptability of Doctor’s services; changes in the health status of Enrollees; and other matters that CMS, OCI, or MDH may require. Doctor certifies that all Enrollee encounter data shall be accurate, complete and truthful.
Enrollee Data. The contractor shall maintain a complete history of enrollee information, including contractor enrollment, primary care provider assignment, third party liability coverage, and Medicare coverage. In addition, the contractor shall capture demographic information relating to the enrollee (age, sex, county, etc.), information related to family linkages, information relating to benefit and service limitations, and information related to health care for enrollees with special needs.
Enrollee Data. Doctor agrees to comply with all requests by CMS, the Minnesota or other state department of health (“MDH”), a health plan company and/or CCMI for information that CMS or MDH requires, the health plan company or CCMI intends to release to purchasers of health care coverage, enrollees and other consumers, including without limitation, CCMI-specific and Doctor-specific quality, outcomes and patient satisfaction data. Doctor consents to the release by health plan companies and CCMI of such information and agrees not to attempt to prohibit or restrict the release of such information. Doctor agrees to provide CCMI, a health plan company, MDH, and CMS all information necessary for the reporting and submission obligations to MDH or CMS, including, but not limited to: all data necessary to characterize the context and purposes of each encounter between an Enrollee and Doctor; patterns of utilization of Doctor’s services; the availability, accessibility and acceptability of Doctor’s services; changes in the health status of Enrollees; and other matters that CMS or MDH may require. Doctor certifies that all Enrollee encounter data shall be accurate, complete and truthful.
