Letter to CMS - Medicaid Managed Care Policies - Agency for ...

Standard VIII: Quality Improvement Program
AGENCY FOR HEALTHCARE ADMINISTRATION
MANAGED CARE ORGANIZATIONS
Compliance Monitoring Tool with Specific Contract Standards
CONTRACT SECTION CONTRACT REQUIREMENT COMPLIANT SCORING
16. Quarterly QI Program
Meetings
CC-VIII.A.2.b
17. Written QI Plan
CC-VIII.A.2.b.
18. Philosophy for Quality
Management
CC - VIII.A.2.b.1
19. Performance Indicators
CC - VIII.A.2.b.2
20. QI Plan Description
The Committee meets no less than
quarterly.
The QI Program Committee is
responsible for the development and
implementation of the written QI Plan,
which incorporates the strategic direction
provided by the governing body.
The QI Plan contains the health plan’s
guiding philosophy for quality
management and identifies any
nationally recognized, standardized
approach used (i.e., PDCA, Rapid Cycle
Improvement, Six Sigma, etc.).
The QI Plan contains the selection of
performance indicators, and the sources
for benchmarking is described.
The QI Plan includes a description of the
following:
a. Health plan positions assigned to the
QI Program including why each
position was chosen and the roles
each positions is expected to fulfill.
b. Specific training regarding quality
that will be provided by the health
Yes
No
Yes
No
Yes
No
Yes
No
a. Yes
No
b. Yes
No
Met
Partially Met
Not Met
Met
Partially Met
Not Met
Met
Partially Met
Not Met
Met
Partially Met
Not Met
Met
Partially Met
Not Met
DOCUMENTS
REVIEWED
FINDINGS
State of Florida Compliance Monitoring_Standard_VIII_F2_07_11
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