Common use of Studies Clause in Contracts

Studies. The Contractor shall conduct an annual Enrollee satisfaction survey beginning six (6) months following enrollment regarding quality, availability, accessibility and satisfaction of care. A description of the methodology to be used in conducting the survey, the percentage of the Enrollees to be surveyed and other survey requirements will be provided to the Plan by the Division. To ensure comparability of results, all Enrollees will receive the same set of questions. The results of the survey and action plans derived from these results must be filed with the Division at least ninety (90) days following completion. The Contractor shall also perform a minimum of four focused studies each year on topics prevalent and significant to the population served. Due to the critical importance of the area of obesity to the Medicaid population, this area should be selected annually for study providing continuous evaluation. At least three (3) other clinical or health service delivery areas completing the required total of four (4) should be selected annually for study from the following topics: Hypertension, Diabetes, Asthma, Congestive Heart Disease, Hemophilia, and Organ Transplants. All studies are to be completed within ninety (90) days prior to the end of the contract year. The Contractor must assure the Division that QM studies are based on adverse or questionable health outcomes, quality issues affecting access to care or other QM studies related specifically to the quality of services provided. The Contractor shall maintain and make available to the Division, CMS, Office of Inspector General (OIG), the Medicaid Fraud Control Unit, and State and Federal Auditors, all studies, reports, protocols, standards, work plans, work sheets, committee minutes, committee reports to the Board of Directors, medical records, and such further documentation as may be required by the Division, concerning quality management activities and corrective actions. In addition to those set forth herein, CMS, in consultation with the State, and other stakeholders, may specify additional performance measures and topics for performance improvement projects to be undertaken by the Contractor.

Studies. The Contractor shall conduct an annual Enrollee satisfaction survey beginning six (6) months following enrollment regarding quality, availability, accessibility and satisfaction of care. A description of the methodology to be used in conducting the survey, the percentage of the Enrollees to be surveyed and other survey requirements will be provided to the Plan by the Division. To ensure comparability of results, all Enrollees will receive the same set of questions. The results of the survey and action plans derived from these results must be filed with the Division at least ninety (90) days following completion. The Contractor shall also perform a minimum of four focused studies each year on topics prevalent and significant to the population served. Due to the critical importance of the area of obesity to the Medicaid population, this area should be selected annually for study providing continuous evaluation. At least three (3) other clinical or health service delivery areas completing the required total of four (4) should be selected annually for study from the following topics: Hypertension, Diabetes, Asthma, Congestive Heart Disease, Hemophilia, and Organ Transplants. All studies are to be completed within ninety (90) days prior to the end of the contract year. The Contractor must assure the Division that QM studies are based on adverse or questionable health outcomes, quality issues affecting access to care or other QM studies related specifically to the quality of services provided. The Contractor shall maintain and make available to the Division, CMS, Office of Inspector General (OIG), the Medicaid Fraud Control Unit, and State and Federal Auditors, all studies, reports, protocols, standards, work plans, work sheets, committee minutes, committee reports to the Board of Directors, medical records, and such further documentation as may be required by the Division, concerning quality management activities and corrective actions. In addition to those set forth herein, CMS, in consultation with the State, and other stakeholders, may specify additional performance measures and topics for performance improvement projects to be undertaken by the Contractor.

Studies. The Contractor shall conduct an annual Enrollee satisfaction survey beginning six (6) months following enrollment regarding quality, availability, accessibility and satisfaction of care. A description of the methodology to be used in conducting the survey, the percentage of the Enrollees to be surveyed and other survey requirements will be provided to the Plan by the Division. To ensure comparability of results, all Enrollees will receive the same set of questions. The results of the survey and action plans derived from these results must be filed with the Division at least ninety (90) days following completion. The Contractor shall also perform a minimum of four focused studies each year on topics prevalent and significant to the population served. Due to the critical importance of the area areas of obesity Infant Mortality and Obesity to the Medicaid population, this area these two areas should be selected annually for study providing continuous evaluation. At least three (3) two other clinical or health service delivery areas completing the required total of four (4) should be selected annually for study from the following topics: Hypertension, Diabetes, Asthma, Congestive Heart Disease, Hemophilia, and Organ Transplants. All studies are to be completed within ninety (90) days prior to the end of the contract year. The Contractor must assure the Division that QM studies are based on adverse or questionable health outcomes, quality issues affecting access to care or other QM studies related specifically to the quality of services provided. The Contractor shall maintain and make available to the Division, CMS, Office of Inspector General (OIG), the OIG),the Medicaid Fraud Control Unit, and State and Federal Auditors, all studies, reports, protocols, standards, work plans, work sheets, committee minutes, committee reports to the Board of Directors, medical records, and such further documentation as may be required by the Division, concerning quality management activities and corrective actions. In addition to those set forth herein, CMS, in consultation with the State, and other stakeholders, may specify additional performance measures and topics for performance improvement projects to be undertaken by the Contractor.