Quality Management and Monitoring. As a model conducted under the authority of Section 1115A of the Social Security Act, the Demonstration and independent evaluation will include and assess quality measures designed to ensure beneficiaries are receiving high quality care. In addition, CMS and the Commonwealth shall conduct a joint comprehensive performance and quality monitoring process that is at least as rigorous as Medicare Advantage, Medicare Prescription Drug, and Medicaid managed care requirements. The reporting frequency and monitoring process will be specified in the three-way contract.
Quality Management and Monitoring. As a model conducted under the authority of section 1115A of the Social Security Act, the Demonstration and independent evaluation will include and assess quality measures designed to ensure beneficiaries are receiving high quality care. In addition, CMS and California shall conduct a joint comprehensive performance and quality monitoring process that is at least as rigorous as Medicare Advantage, Medicare Prescription Drug, and Medicaid managed care requirements. The reporting frequency and monitoring process will be specified in the three-way contract.
Quality Management and Monitoring. As a model conducted under the authority of Section 1115A of the Act, the Demonstration and independent evaluation will include and assess quality measures designed to ensure beneficiaries are receiving high quality care (see Appendix 7 for additional details).
Quality Management and Monitoring. As a model conducted under the authority of Section 1115A of the Social Security Act, the Demonstration and independent evaluation will include and assess quality measures designed to ensure Beneficiaries are receiving high quality care. In addition, CMS and the State shall continue to conduct comprehensive performance and quality monitoring processes. During the Demonstration, and unless otherwise identified in this MOU, MSHO Plans will be subject to the prevailing Medicare Advantage performance measurement and Part D requirements, public reporting systems and required quality initiatives, including Chronic Care Improvement Programs (CCIP), Quality Improvement Projects (QIP), and Medicaid External Quality Review Organization (EQRO) activities as well as all current Medicaid measurement and reporting systems. In addition, the State will test new quality measurement approaches that may include new measures, revisions to existing surveys, translating surveys into different languages to increase Enrollee response rates, and/or revised data sharing arrangements and analysis. New measures will be tested in conjunction with national consensus organizations and CMS. The measures are discussed further in Appendix 4.
Quality Management and Monitoring. As a model conducted under the authority of Section 1115A of the Social Security Act, the Demonstration and independent evaluation will include and assess quality measures designed to ensure beneficiaries are receiving high quality care (see Appendix 7 for additional detail).
Quality Management and Monitoring. As a model conducted under the authority of Section 1115A of the Social Security Act, the Demonstration and independent evaluation will include and assess quality measures designed to ensure Enrollees are receiving quality care. In addition, CMS and the State shall conduct a joint comprehensive performance and quality monitoring process that is at least as rigorous as the Medicare Advantage, Part D, the Rhode Island Comprehensive Section 1115(a) demonstration, and the State’s Medicaid managed care program requirements. The reporting frequency and monitoring process will be specified in the Three-way Contract.
Quality Management and Monitoring. As a model conducted under the authority of Section 1115A of the Social Security Act, the Demonstration and independent evaluation will include and assess quality measures designed to ensure Participants are receiving high quality care. In addition, CMS and the State shall conduct a joint comprehensive performance and quality monitoring process that is at least as rigorous as the Medicare Advantage, Medicare Part D, the State’s Section 1115(a) demonstration, and the State’s Medicaid Section 1915(c) Comprehensive OPWDD Waiver and managed care programs’ requirements. The reporting frequency and monitoring process will be specified in the Three-way Contract. This section of the MOU does not relieve NYSDOH and OPWDD of the oversight responsibilities required under the 1915(c) OPWDD Comprehensive Waiver as outlined in Appendix 5 of this MOU.
