Common use of Provider Participation/Cooperation with UR/QM Programs Clause in Contracts

Provider Participation/Cooperation with UR/QM Programs. As applicable, PROVIDER agrees to participate in, cooperate and comply with, and abide by decisions of XXXXX, MCO, and/or Plan(s) with respect to XXXXX’, MCO’s, and/or Plan(s)’ medical policies and medical management programs, procedures or activities; quality improvement and performance improvement programs, procedures and activities; and utilization and management review; care coordination activities including, but not limited to, medical record reviews, HEDIS reporting, disease management programs, case management, clinical practice guidelines, and other quality measurements to improve Members’ care. PROVIDER further agrees to comply and cooperate with an independent quality review and improvement organization’s activities pertaining to the provision of Covered Services for Medicare, Medicare Advantage, and Medical Assistance Program Members. PROVIDER shall implement a continuous quality improvement action plan if areas for improvement are identified.

Provider Participation/Cooperation with UR/QM Programs. As applicable, PROVIDER agrees to participate in, cooperate and comply with, and abide by decisions of XXXXX, MCO, and/or Plan(s) with respect to XXXXX’, MCO’s, and/or Plan(s)’ medical policies and medical management programs, procedures or activities; quality improvement and performance improvement programs, procedures and activities; and utilization and management review; care coordination activities including, but not limited to, medical record reviews, HEDIS reporting, disease management programs, case management, clinical practice guidelines, and other quality measurements to improve Members’ Member’s care. PROVIDER further agrees to comply and cooperate with an independent quality review and improvement organization’s activities pertaining to the provision of Covered Services for Medicare, Medicare Advantage, and Medical Assistance Program Members. PROVIDER shall implement a continuous quality improvement action plan if areas for improvement are identified.

Provider Participation/Cooperation with UR/QM Programs. As applicable, PROVIDER agrees to participate in, cooperate and comply with, and abide by decisions of XXXXX, MCO, and/or Plan(s) with respect to XXXXX’, MCO’s, and/or Plan(s)’ medical policies and medical management programs, procedures or activities; quality improvement and performance improvement programs, procedures and activities; and utilization and management review; , care coordination activities including, but not limited to, medical record reviews, HEDIS reporting, disease management programs, case management, clinical practice guidelines, and other quality measurements to improve Members’ care. PROVIDER further agrees to comply and cooperate with an independent quality review and improvement organization’s activities pertaining to the provision of Covered Services for Medicare, Medicare Advantage, and Medical Assistance Program Members. PROVIDER shall implement a continuous quality improvement action plan if areas for improvement are identified.

Provider Participation/Cooperation with UR/QM Programs. As applicable, PROVIDER agrees to participate in, cooperate and comply with, and abide by decisions of XXXXX, MCO, and/or Plan(s) with respect to XXXXX’, MCO’s, and/or Plan(s)’ medical policies and medical management programs, procedures or activities; quality improvement and performance improvement programs, procedures and activities; and utilization and management review; care coordination activities including, but not limited to, medical record reviews, HEDIS reporting, disease management programs, case management, clinical practice guidelines, and other quality measurements to improve MembersMember(s)’ care. PROVIDER further agrees to comply and cooperate with an independent quality review and improvement organization’s activities pertaining to the provision of Covered Services for Medicare, Medicare Advantage, and Medical Assistance Program Members. PROVIDER shall implement a continuous quality improvement action plan if areas for improvement are identified.