MDCH Reviews Clause Samples

MDCH Reviews. A. As used in this section, a review is an examination or inspection by the MDCH or its agent, of policies and practices, in an effort to verify compliance with requirements of this contract. B. The MDCH will schedule reviews at mutually acceptable start dates to the extent possible, with the exception of those reviews for which advance announcement is prohibited by rule or federal regulation, or when the deputy director for the Health Care Administration determines that there is demonstrated threat to consumer health and welfare or substantial threats to access to care. C. Except as precluded in 9.3.1 (A) above, the guideline, protocol and/or instrument to be used to review the PIHP, or a detailed agenda if no protocol exists, shall be provided to the PIHP at least 30 days prior to the review. D. At the conclusion of the review, the MDCH shall conduct an exit interview with the PIHP. The purpose of the exit interview is to allow the MDCH to present the preliminary findings and recommendations. E. Following the exit review, the MDCH shall generate a report within 45 days identifying the findings and recommendations that require a response by the PIHP. 1. The PIHP shall have 30 days to provide a Plan of Correction (POC) for achieving compliance. The PIHP may also present new information to the MDCH that demonstrates it was in compliance with the questioned provisions at the time of the review. (New information can be provided anytime between the exit interview and the POC). When access or care to individuals is a serious issue, the PIHP may be given a much shorter period to initiate corrective actions, and this condition may be established, in writing, as part of the exit conference identified in C above. 2. The MDCH will review the POC, seek clarifying or additional information from the PIHP as needed, and issue an approval of the POC within 30 days of having required information from the PIHP. The MDCH will take steps to monitor the PIHP's implementation of the POC as part of performance monitoring. 3. The MDCH shall protect the confidentiality of the records, data and knowledge collected for or by individuals or committees assigned a peer review function in planning the process of review and in preparing the review or audit report for public release F. The PIHP can appeal findings reflected in review reports through the dispute resolution process identified in this contract.