Quality Assessment and Performance Improvement Plans Sample Clauses

Quality Assessment and Performance Improvement Plans. In accordance with Section 2.13.B.5 of the Contract, ACPPs must submit to EOHHS an annual QI workplan that broadly describes ACPP QI initiatives that are conducted as part of the plan’s comprehensive quality assurance and performance improvement (QAPI) program. The QI plan should minimally include the QIPs and performance measures referenced in Appendices B and Q. Listed below are the Per Member Per Month (PMPM) Base Capitation Rates for Contract Year 5 (January 1, 2022 through December 31, 2022) (also referred to as Rate Year 2022 or RY22), subject to state appropriation and all necessary federal approvals; Base Capitation Rates do not include EOHHS adjustments described in Sections 4.2.C and 4.2.E. of the Contract. In addition to the Base Capitation Rates tables below, additional tables include the add-ons for the Contract Year for CBHI Services as described in Section 4.5.D, for ABA Services as described in Section 4.5.E, and for SUD Risk Sharing Services as described in Section 4.5.I. The add-ons for CBHI Services, ABA Services and SUD Risk Sharing Services are the same for all Regions and will be added to the Risk Adjusted Capitation Rates as defined in Section 4.2.E. Effective January 1, 2022 – June 30, 2022 REGION NON-HIGH COST DRUG / NON-HCV MEDICAL COMPONENT HCV COMPONENT NON-HCV HIGH COST DRUG COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) (per member per month) (per member per month) Effective January 1, 2022 – June 30, 2022 REGION NON-HIGH COST DRUG / NON-HCV MEDICAL COMPONENT HCV COMPONENT NON-HCV HIGH COST DRUG COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) (per member per month) (per member per month) Effective January 1, 2022 – June 30, 2022 REGION NON-HIGH COST DRUG / NON-HCV MEDICAL COMPONENT HCV COMPONENT NON-HCV HIGH COST DRUG COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) (per member per month) (per member per month) Effective January 1, 2022 – June 30, 2022 REGION NON-HIGH COST DRUG / NON-HCV MEDICAL COMPONENT HCV COMPONENT NON-HCV HIGH COST DRUG COMPONENT ADMINISTRATIVE COMPONENT TOTAL BASE CAPITATION RATE (per member per month) (per member per month) (per member per month) (per member per month) (per member per month) Effective January 1, 2022 – June 30, 2022 REGION NON-HIGH COST DRUG ...
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Quality Assessment and Performance Improvement Plans. In accordance with Section 2.13.B.5 of the Contract, ACPPs must submit to EOHHS an annual QI workplan that broadly describes ACPP QI initiatives that are conducted as part of the plan’s comprehensive quality assurance and performance improvement (QAPI) program. The QI plan should minimally include the QIPs and performance measures referenced in Appendices B and Q. The Contractor shall provide to each Enrollee each of the ACO Covered Services listed below in an amount, duration, and scope that is Medically Necessary (as defined in Section 1 of this Contract), provided that the Contractor is not obligated to provide any ACO Covered Service in excess of any service limitation expressly set forth below. Except to the extent that such service limitations are set forth below, the general descriptions below of ACO Covered Services do not limit the Contractor’s obligation to provide all Medically Necessary services. Coverage Types Service MassHealth Standard & CommonHealth Enrollees MassHealth Family Assistance Enrollees CarePlus Acupuncture Treatment - the insertion of metal needles through the skin at certain points on the body, with or without the use of herbs, an electric current, heat to the needles or skin, or both, for pain relief or anesthesia. ✓ ✓ ✓ Acute Inpatient Hospital –all inpatient services such as daily physician intervention, surgery, obstetrics, radiology, laboratory, and other diagnostic and treatment procedures. Coverage of acute inpatient hospital services shall include Administratively Necessary Days. Administratively Necessary Day shall be defined as a day of Acute Inpatient Hospitalization on which an Enrollee’s care needs can be provided in a setting other than an Acute Inpatient Hospital and on which an Enrollee is clinically ready for discharge. ✓ ✓ ✓ Ambulatory Surgery/Outpatient Hospital Care - outpatient surgical, related diagnostic, medical and dental services. ✓ ✓ ✓ Audiologist – audiologist exams and evaluations. See related hearing aid services. ✓ ✓ ✓ Behavioral Health Services – see Appendix C, Exhibit 3. ✓ ✓ ✓ Breast Pumps – to expectant and new mothers as specifically prescribed by their attending physician, consistent with the provisions of the Affordable Care Act of 2010 and Section 274 of Chapter 165 of the Acts of 2014, including but not limited to double electric breast pumps one per birth or as medically necessary. ✓ ✓ ✓ Certain COVID-19 Specimen Collection and Testing – Specimen collection codes G2023 and G2024 billed w...
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Quality Assessment and Performance Improvement Plans. In accordance with Section 2.13.B.5 of the Contract, MCOs must submit to EOHHS an annual QI workplan that broadly describes MCO QI initiatives that are conducted as part of the plan’s comprehensive quality assurance and performance improvement (QAPI) program. The QI plan should minimally include the QIPs and performance measures referenced in Appendix B. Exhibit 1: Performance Measures # Measure Name Measure Description Data Source Measure Xxxxxxx NQF No. Reporting Level* 1 Childhood Immunization Status Percentage of members who received all recommended immunizations by their 2nd birthday Hybrid NCQA 0038 MCO 2 Immunizations for Adolescents Percentage of members 13 years of age who received all recommended vaccines, including the HPV series Hybrid NCQA 1407 MCO 3 Timeliness of Prenatal Care Percentage of deliveries in which the member received a prenatal care visit in the first trimester or within 42 days of enrollment Hybrid NCQA 1517 MCO 4 Oral Health Evaluation Percentage of members under age 21 years who received a comprehensive or periodic oral evaluation during the year Claims ADA DQA 2517 MCO (calculated by EOHHS) 5 Asthma Medication Ratio Percentage of members 5 to 64 years of age who were identified as having persistent asthma and had a ratio of controller medications to total asthma medications of 0.50 or greater Claims NCQA 1800 MCO 6 Controlling High Blood Pressure Percentage of members 18 to 64 years of age with hypertension and whose blood pressure was adequately controlled Hybrid NCQA 0018 MCO 7 Comprehensive Diabetes Care: A1c Poor Control Percentage of members 18 to 64 years of age with diabetes whose most recent HbA1c level demonstrated poor control (> 9.0%) Hybrid NCQA 0059 MCO # Measure Name Measure Description Data Source Measure Xxxxxxx NQF No. Reporting Level* 8 Metabolic Monitoring for Children and Adolescents on Antipsychotics Percentage of members 1 to 17 years of age who had two or more antipsychotic prescriptions and received metabolic testing Claims NCQA 2800 MCO 9 ED Visits for Individuals with Mental Illness, Addiction, or Co- occurring Conditions Risk adjusted ratio (obs/exp) of ED visits for members 18 to 64 years of age identified with a diagnosis of serious mental illness, substance addiction, or co-occurring conditions Claims EOHHS NA MCO (calculated by EOHHS) 10 Follow-Up After Emergency Department Visit for Mental Illness (7 days) Percentage of ED visits for members 6 to 64 years of age with a principal diagnosis of me...
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Quality Assessment and Performance Improvement Plans. In accordance with section 2.13.B.5 of the Contract, SCOs shall submit to EOHHS a comprehensive quality assurance and performance improvement (QAPI) program plan. The QI plan shall minimally include the PIPs and performance measures referenced in this Appendix. 1. Adherence to Antipsychotic Medications for Individuals With‌ Schizophrenia (SAA) 1879 HEDIS Behavioral Health and Substance Use Disorder 2. Advance Care Planning 0326 HEDIS Medication Management and Care Coordination 3. Antidepressant Medication Management (AMM) 0105 HEDIS Behavioral Health and Substance Use Disorder
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Related to Quality Assessment and Performance Improvement Plans

  • Performance Improvement Plan timely and accurate completion of key actions due within the reporting period 100 percent The Supplier will design and develop an improvement plan and agree milestones and deliverables with the Authority 3.2 The Authority may from time to time make changes to the KPIs measured as set out in paragraph 3.1 above and shall issue a replacement version to the Supplier. The Authority shall give notice In Writing of any such change to the KPIs measured and shall specify the date from which the replacement KPIs must be used for future reports. Such date shall be at least thirty (30) calendar days following the date of the notice to the Supplier.

  • The Performance Improvement Process (a) The Performance Improvement Process will focus on the risks of non- performance and problem-solving. It may include one or more of the following actions: (1) a requirement that the HSP develop and implement an improvement plan that is acceptable to the LHIN; (2) the conduct of a Review; (3) a revision and amendment of the HSP’s obligations; and (4) an in-year, or year end, adjustment to the Funding, among other possible means of responding to the Performance Factor or improving performance. (b) Any performance improvement process begun under a prior service accountability agreement that was not completed under the prior agreement will continue under this Agreement. Any performance improvement required by a LHIN under a prior service accountability agreement will be deemed to be a requirement of this Agreement until fulfilled or waived by the LHIN.

  • CONTRACTOR PERFORMANCE AUDIT The Contractor shall allow the Authorized User to assess Contractor’s performance by providing any materials requested in the Authorized User Agreement (e.g., page load times, response times, uptime, and fail over time). The Authorized User may perform this Contractor performance audit with a third party at its discretion, at the Authorized User’s expense. The Contractor shall perform an independent audit of its Data Centers, at least annually, at Contractor expense. The Contractor will provide a data owner facing audit report upon request by the Authorized User. The Contractor shall identify any confidential, trade secret, or proprietary information in accordance with Appendix B, Section 9(a), Confidential/Trade Secret Materials.

  • Improvement Plans A professional improvement plan is a clearly articulated assistance program for a teacher whose student growth measure dimension of the evaluation is below the expected level of student growth. For the purposes of this agreement, improvement plans shall be based on the individual student growth measure level, and not for overall subjects or classes taught.

  • Post-Commercial Operation Date Testing and Modifications Each Party shall at its own expense perform routine inspection and testing of its facilities and equipment in accordance with Good Utility Practice as may be necessary to ensure the continued interconnection of the Large Generating Facility with the Participating TO’s Transmission System in a safe and reliable manner. Each Party shall have the right, upon advance written notice, to require reasonable additional testing of the other Party’s facilities, at the requesting Party’s expense, as may be in accordance with Good Utility Practice.

  • Tenant Improvement Plans Any work proposed by Tenant (the “Tenant Improvements”) shall be subject to Landlord’s reasonable prior approval and shall be subject to the other terms and conditions of this Exhibit C; provided that it will be reasonable for Landlord to withhold its approval or consent (as and when applicable under this Exhibit C) if Landlord’s Mortgagee has not consented to the matter that is the subject of such approval or consent. All architectural, engineering and other design fees shall be paid by Tenant. Tenant shall use its architect, engineers and other design professionals, all of whom shall comply with any applicable licensing or governmental requirements of the City of Seattle and the State of Washington; Tenant’s architect shall be approved by Landlord (“Tenant’s Architect”), which approval shall not be unreasonably withheld, conditioned or delayed. Landlord shall also be entitled to receive a copy of the agreement between Tenant and Tenant’s Architect (the “Architect Agreement”). Tenant shall cause Tenant’s Architect to prepare a draft space plan (the “Space Plan”) for the Tenant Improvements and shall submit the proposed Space Plan to Landlord for the latter’s approval (not to be unreasonably withheld) in a time period to allow Tenant to timely complete its Tenant Improvements under this Lease. Landlord shall deliver to Tenant any written objections, questions or comments of Landlord with regard to the Space Plan within ten (10) business days of receipt; Landlord’s consent thereto shall be deemed given if not denied in writing within said ten (10) business day period. If Landlord denies its approval, it shall specify the reasons for doing so in detail. Tenant shall cause the Space Plan to be revised to address such written comments and shall resubmit said Space Plan to Landlord for approval. Such process shall continue until Landlord has approved the Space Plan. Tenant’s Architect shall then prepare working drawings and specifications for the Tenant Improvements, including architectural, structural, plumbing, mechanical, electrical, and fire protection drawings as required, suitable for permit application (the “Working Drawings”) and shall submit the proposed Working Drawings to Landlord for the latter’s approval in a time period to allow Tenant to timely complete its Tenant Improvements under this Lease. The Space Plan and Working Drawings shall be subject to Landlord’s approval, which Landlord agrees shall not be unreasonably withheld, conditioned, or delayed. Landlord shall not be deemed to have acted unreasonably if it withholds its approval thereof because, in Landlord’s reasonable opinion, the work, as described in any such item: (i) is likely to adversely affect Building Systems, the structure of the Building or the safety of the Building and/or their occupants; (ii) might impair Landlord’s ability to furnish services to Tenant or other tenants in the Building; (iii) would materially increase the cost of operating the Building; (iv) would violate any governmental laws, rules or ordinances (or interpretations thereof); (v) contains or uses hazardous or toxic materials or substances; (vi) would negatively affect the appearance of the Building; (vii) is reasonably likely to adversely affect another tenant’s premises; or (viii) is prohibited by any ground lease affecting the Building or any mortgage, trust deed or other instrument encumbering the Building. Landlord shall deliver to Tenant any written objections, questions or comments of Landlord with regard to the Working Drawings, within ten (10) business days of Landlord’s receipt of the Working Drawings; Landlord’s consent thereto shall be deemed given if not denied in writing within said ten (10) business day period. If Landlord denies its approval, it shall specify the reasons for doing so in detail. Tenant shall cause the Working Drawings to be revised to address such written comments and shall resubmit said Working Drawings to Landlord for approval. Landlord may, when approving the Tenant Improvement Plans, elect to require Tenant to remove any Non-Standard Improvements which are made to the Premises. If Landlord so elects, Tenant shall, at its own cost, restore the Premises to the condition designated by Landlord in its election, before the last day of the Term. Such process shall continue until both parties have approved the Working Drawings. Landlord’s approval of the Space Plan and/or the Working Drawings shall not be deemed any representation or warranty that the same comply with applicable codes.

  • Commercial Operation Date Testing and Modifications Prior to the Commercial Operation Date, the Connecting Transmission Owner shall test the Connecting Transmission Owner’s Attachment Facilities and System Upgrade Facilities and System Deliverability Upgrades and Developer shall test the Large Generating Facility and the Developer Attachment Facilities to ensure their safe and reliable operation. Similar testing may be required after initial operation. Developer and Connecting Transmission Owner shall each make any modifications to its facilities that are found to be necessary as a result of such testing. Developer shall bear the cost of all such testing and modifications. Developer shall generate test energy at the Large Generating Facility only if it has arranged for the injection of such test energy in accordance with NYISO procedures.

  • Quarterly Contractor Performance Reporting Customers shall complete a Contractor Performance Survey (Exhibit I) for each Contractor on a Quarterly basis. Customers will electronically submit the completed Contractor Performance Survey(s) to the Department Contract Manager no later than the due date indicated in Contract Exhibit D, Section 17, Additional Special Contract Conditions. The completed Contractor Performance Survey(s) will be used by the Department as a performance-reporting tool to measure the performance of Contractors. The Department reserves the right to modify the Contractor Performance Survey document and introduce additional performance-reporting tools as they are developed, including online tools (e.g. tools within MyFloridaMarketPlace or on the Department's website).

  • Data Protection Impact Assessment and Prior Consultation Processor shall provide reasonable assistance to the Company with any data protection impact assessments, and prior consultations with Supervising Authorities or other competent data privacy authorities, which Company reasonably considers to be required by article 35 or 36 of the GDPR or equivalent provisions of any other Data Protection Law, in each case solely in relation to Processing of Company Personal Data by, and taking into account the nature of the Processing and information available to, the Contracted Processors.

  • Constructability Review Prepare detailed interdisciplinary constructability review within Fourteen (14) days of receipt of the plans from the District that: 10.1.2.1.6.1 Ensures construction documents are well coordinated and reviewed for errors; 10.1.2.1.6.2 Identifies to the extent known, construction deficiencies and areas of concern; 10.1.2.1.6.3 Back-checks design drawings for inclusion of modifications; and 10.1.2.1.6.4 Provides the District with written confirmation that: 10.1.2.1.6.4.1 Requirements noted in the design documents prepared for the Project are consistent with and conform to the District's Project requirements and design standards. 10.1.2.1.6.4.2 Various components have been coordinated and are consistent with each other so as to minimize conflicts within or between components of the design documents.

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