State and Federal Reviews. Contractor agrees to make available to the State and/or its designees on an as needed basis, medical and other records for review of quality of care and access issues. CMS and/or the State may designate an outside review agency to conduct an evaluation of the Rhode Island Medical Assistance dental program and its progress toward achieving program goals. Contractor agrees to make available to CMS’ and/or the State’s outside review agency medical and other records for review as requested. The Contractor will undergo annual, external, independent reviews of the quality, timeliness, and access to the services covered under each contract, in accordance with 42 C.F.R. § 438.350.
State and Federal Reviews. Contractor agrees to make available to the State and/or its designees on an as needed basis, medical and other records for review of quality of care and access issues. CMS and/or the State may designate an outside review agency to conduct an evaluation of the Rhode Island Medical Assistance managed care program and its progress toward achieving program goals. Contractor agrees to make available to CMS’ and/or the State’s outside review agency medical and other records for review as requested.
