Quality Enhancements. In addition to the covered services specified in this section, the Health Plan shall offer quality enhancements (QE) to enrollees as specified below. a. The Health Plan shall offer QEs in community settings accessible to enrollees. b. The Health Plan shall provide information in the enrollee and provider handbooks on the QEs and how to access related services. c. The Health Plan shall develop and maintain written policies and procedures to implement QEs. d. The Health Plan may cosponsor the annual training of providers, provided that the training meets the provider training requirements for the programs listed below. The Health Plan is encouraged to actively collaborate with community agencies and organizations, including CHDs, local Early Intervention Programs, Healthy Start Coalitions and local school districts in offering these services. e. If the Health Plan involves the enrollee in an existing community program for purposes of meeting the QE requirement, the Health Plan shall ensure documentation in the enrollee’s medical record of referrals to the community program and follow up on the enrollee's receipt of services from the community program. f. QE programs shall include, but not be limited to, the following:
Appears in 4 contracts
Samples: Standard Contract (Wellcare Health Plans, Inc.), Standard Contract (Wellcare Health Plans, Inc.), Standard Contract (Wellcare Health Plans, Inc.)
Quality Enhancements. In addition to the covered services specified in this section, the Health Plan shall offer quality enhancements (QE) to enrollees as specified below.
a. The Health Plan shall offer QEs in community settings accessible to enrollees.
b. The Health Plan shall provide information in the enrollee and provider handbooks on the QEs and how to access related services.
c. The Health Plan shall develop and maintain written policies and procedures to implement QEs.
d. The Health Plan may cosponsor the annual training of providers, provided that the training meets the provider training requirements for the programs listed below. The Health Plan is encouraged to actively collaborate with community agencies and organizations, including CHDs, local Early Intervention Programs, Healthy Start Coalitions and local school districts in offering these services.
e. If the Health Plan involves the enrollee in an existing community program for purposes of meeting the QE requirement, the Health Plan shall ensure documentation in the enrollee’s medical record of referrals to the community program and follow up on the enrollee's ’s receipt of services from the community program.
f. QE programs shall include, but not be limited to, the following:
Appears in 1 contract
Samples: Standard Contract (Amerigroup Corp)
