Quality and Member Access Committee. The Contractor shall establish and maintain an ongoing Quality and Member Access Committee (QMAC) composed of Members, individuals from consumer advocacy groups or the community who represent the interests of the Member population. Members of the committee shall be consistent with the composition of the Member population, including such factors as aid category, gender, geographic distribution, parents, as well as adult members and representation of racial and ethnic minority groups. Member participation may be excused by the Department upon a showing by Contractor of good faith efforts to obtain Member participation. Responsibilities of the committee shall include: A. Providing review and comment on quality and access standards; B. Providing review and comment on the Grievance and Appeals process as well as policy modifications needed based on review of aggregate Grievance and Appeals data; C. Proving review and comment on Member Handbooks; D. Reviewing Member education materials prepared by the Contractor; E. Recommending community outreach activities; and F. Providing reviews of and comments on Contractor and Department policies that affect Members. The list of the Members participating with the QMAC shall be submitted to the Department annually.
Appears in 5 contracts
Samples: Managed Care Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Contract, Medicaid Managed Care Contract
