Standards of Care. The Contractor must adopt practice guidelines consistent with current standards of care, complying with recommendations of professional specialty groups or the guidelines of programs such as the American Academy of Pediatrics, the American Academy of Family Physicians, the U.S. Task Force on Preventive Care, the New York State Child/Teen Health Program (C/THP) standards for provision of care to individuals under age 21, the American Medical Association's Guidelines for Adolescent and Preventive Services, the US Department of Health and Human Services Center for Substance Abuse Treatment, the American College of Obstetricians and Gynecologists, the American Diabetes Association, and the AIDS Institute clinical standards for adult, adolescent, and pediatric care. The Contractor must have mechanisms in place to disseminate any changes in practice guidelines to its network providers at least annually, or more frequently, as appropriate. The Contractor shall develop and implement protocols for identifying providers who do not adhere to practice guidelines and for making reasonable efforts to improve the performance of these providers. Annually, the Contractor shall select a minimum of two practice guidelines and monitor
Appears in 5 contracts
Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)
Standards of Care. The Contractor must adopt practice guidelines consistent with current standards of care, complying with recommendations of professional specialty groups or the guidelines of programs such as the American Academy of Pediatrics, the American Academy of Family Physicians, the U.S. Task Force on Preventive Care, the New York State Child/Teen Health Program (C/THP) standards for provision of care to individuals under age 21, the American Medical Association's Guidelines for Adolescent and Preventive Services, the US Department of Health and Human Services Center for Substance Abuse Treatment, the American College of Obstetricians and Gynecologists, the American Diabetes Association, and the AIDS Institute clinical standards for adult, adolescent, and pediatric care. The Contractor must have mechanisms in place to disseminate any changes in practice guidelines to its network providers at least annually, or more frequentlyFREQUENTLY, as appropriate. The Contractor shall develop and implement protocols for identifying providers who do not adhere to practice guidelines and for making reasonable efforts to improve the performance of these providers. Annually, the Contractor shall select a minimum of two practice guidelines and monitor
Appears in 1 contract
Samples: Medicaid Managed Care Model Contract (Amerigroup Corp)
Standards of Care. The Contractor must adopt practice guidelines consistent with current standards of care, complying with recommendations of professional specialty groups or the guidelines of programs such as the American Academy of Pediatrics, the American Academy of Family Physicians, the U.S. Task Force on Preventive Care, the New York State Child/Teen Health Program (C/THP) standards for provision of care to individuals under age 21, the American Medical Association's Guidelines for Adolescent and Preventive Services, the US Department of Health and Human Services Center for Substance Abuse Treatment, the American College of Obstetricians and Gynecologists, the American Diabetes Association, and the AIDS Institute clinical standards for adult, adolescent, and pediatric care. The Contractor must have mechanisms in place to disseminate any changes in practice guidelines to its network providers at least annually, or more frequently, as appropriate. The Contractor shall develop and implement protocols for identifying providers who do not adhere to practice guidelines and for making reasonable efforts to improve the performance of these providers. Annually, the Contractor shall select a minimum of two practice guidelines and monitormonitor SECTION 16 (QUALITY ASSURANCE) OCTOBER 1, 2004 16-1 performance of appropriate providers (or a sample of providers) against such guidelines.
Appears in 1 contract
Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)
Standards of Care. The Contractor must adopt practice guidelines consistent with current standards of care, complying with recommendations of professional specialty groups or the guidelines of programs such as the American Academy of Pediatrics, the American Academy of Family Physicians, the U.S. Task Force on Preventive Care, the New York State Child/Teen Health Program (C/THP) standards for provision of care to individuals under age 21, the American Medical Association's Guidelines for Adolescent and Preventive Services, the US Department of Health and Human Services Center for Substance Abuse Treatment, the American College of Obstetricians and Gynecologists, the American Diabetes Association, and the AIDS Institute clinical standards for adult, adolescent, and pediatric care. The Contractor must have mechanisms in place to disseminate any changes in practice guidelines to its network providers at least annually, or more frequently, as appropriate. The Contractor shall develop and implement protocols for identifying providers who do not adhere to practice guidelines and for making reasonable efforts to improve the performance of these providers. Annually, the Contractor shall select a minimum of two practice guidelines and monitormonitor SECTION 16 (QUALITY ASSURANCE) OCTOBER 1, 2004 16-1 performance of appropriate providers (or a sample of providers) against such guidelines. SECTION 16 (QUALITY ASSURANCE) OCTOBER 1, 2004 16-2
Appears in 1 contract
Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)
Standards of Care. The Contractor must adopt practice guidelines consistent with current standards of care, complying with recommendations of professional specialty groups or the guidelines of programs such as the American Academy of Pediatrics, the American Academy of Family Physicians, the U.S. Task Force on Preventive Care, the New York State Child/Child Teen Health Program (C/THP) standards for provision of care to individuals under age 21, the American Medical Association's Guidelines for Adolescent and Preventive Services, the US Department of Health and Human Services Center for Substance Abuse Treatment, the American College of Obstetricians and Gynecologists, the American Diabetes Association, and the AIDS Institute clinical standards for adult, adolescent, and pediatric care. The Contractor must have mechanisms in place to disseminate any changes in practice guidelines to its network providers at least annually, or more frequently, as appropriate. The Contractor shall develop and implement protocols for identifying providers who do not adhere to practice guidelines and for making reasonable efforts to improve the performance of these providers. Annually, the Contractor shall select a minimum of two practice guidelines and monitor
Appears in 1 contract
Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)