Oversight Process for Subcontractors Sample Clauses
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Oversight Process for Subcontractors. DVHA will remain accountable for any functions and responsibilities that it delegates to any subcontractors. DVHA must assure that all subcontractors meet the requirements of 42 CFR 438 that are appropriate to the service or activity delegated under the subcontract in accordance with the requirements and effective dates specified in 42 CFR 438.230. Before any delegation can take place, DVHA must evaluate the prospective subcontractor’s ability to perform the activities to be delegated. DVHA monitors the subcontractor’s performance via a formal review according to a periodic schedule established by the State, consistent with industry standards or State laws and regulations. If DVHA identifies material deficiencies and areas of improvement meriting the implementation of a corrective action plan (CAP), DVHA will inform AHS and initiate the process for initiating a CAP, in consultation with AHS. AHS retains oversight of the Medicaid program related to DVHA and its IGA partner’s overall accountability and adherence to the Global Commitment to Health Demonstration Special Terms and Conditions.
Oversight Process for Subcontractors. The OVHA shall provide oversight for Medicaid enrollee services through the following: • At least biennially, the OVHA will complete Minimum Standards and Clinical Care Audits. The OVHA will review an established percentage of enrollee records for emergency care, actions and appeal outcomes, service plan development and utilization review of reported service records; and • Biennially, on alternating years with the Minimum Standards and Clinical Care Audit, the OVHA will conduct a Program Review which will evaluate access to services, its subcontractor Department practices, enrollee outcomes, operational management, and administrative structures. The OVHA will maintain evaluation tools, reports, improvement plans, and reported service data profiles used in the service plan and utilization review monitoring activity. The OVHA shall also conduct ongoing monitoring of its Departmental subcontractors through the review of required reports and data submissions.
Oversight Process for Subcontractors. The MCE oversees and is accountable for any functions and responsibilities that it delegates to any subcontractors. Before any delegation can take place, the MCE must evaluate the prospective subcontractor’s ability to perform the activities to be delegated. The MCE monitors the subcontractor’s performance via a formal review according to a periodic schedule established by the State, consistent with industry standards or State MCE laws and regulations. If the MCE identifies deficiencies or areas for improvement, the MCE will follow its operating procedures for initiating corrective action.