Common use of Georgia Clause in Contracts

Georgia. Purpose » Assure scope of practice review is completed for all applicable clinical staff in health plan and medical group. » Identify and clarify all scope of practice issues identified. » Report findings of scope of practice review to Regional President and Medical Director. » Develop a process and identify accountabilities to assure corrective action plans are developed, implemented, evaluated for effectiveness and monitored over time to assure required practice changes have occurred. Membership Membership consists of representatives from health plan, medical group, risk management, labor and HR functions for Health Plan and Medical Group. Sponsors are Xx. Xxxxx Xxxxxxx and Xxxxxx Xxxxxx as leaders of the HealthConnect Implementation Project. Reporting » Regional President » TSPMG Medical Director » Chief Compliance Officer Region SOP Committee Structure and Process Summary MID-ATLANTIC STATES Purpose The Committee Will: » Develop and maintain an inventory of scope of practice requirements by position type; » Review and approve protocols, policies and procedures created by the Committee to meet scope of practice regulations and requirements for unlicensed and licensed clinical and support staff; » Develop and oversee implementation of annual scope of practice work plan and action items; » Establish a mechanism for recurring review of clinical position descriptions; » Evaluate existing and proposed clinical practices for scope of practice risks and/or violations and the impact on scope of practice; » Develop and oversee scope of practice training and education throughout the region; » Coordinate with existing committees and work groups to ensure that scope of practice issues are addressed effectively; » Provide recommendations to Committee sponsors and senior leadership regarding identified opportunities for change; » Monitor corrective actions to ensure continued compliance with prescribed scope of practice requirements and regulations; » Collaborate with appropriate departments to ensure that changes are integrated into existing systems, policies and processes; and » Maintain a reporting relationship with the Regional Quality Improvement Committee and the Compliance Department. Reporting to occur not less than quarterly. Subcommittees may be created as needed to facilitate completion of specialized tasks.

Georgia. Purpose » Assure scope of practice review is completed for all applicable clinical staff in health plan and medical group. » Identify and clarify all scope of practice issues identified. » Report findings of scope of practice review to Regional President and Medical Director. » Develop a process and identify accountabilities to assure corrective action plans are developed, implemented, evaluated for effectiveness and monitored over time to assure required practice changes have occurred. 2005 Scope of Practice BTG Report, Pages 14 –17 SECTION X: REFERENCES Reference 1: National Compliance Plan Reference 2: Regional Scope of Practice Committee Structure and Process Exhibit 1.C.4.(1) continued Region SOP Committee Structure and Process Summary COLORADO Purpose The purpose of the Scope of Practice Oversight Committee is to provide region-wide monitoring, leadership and oversight for compliance with legal, accreditation and organizational scope of practice requirements. To achieve this purpose, the committee will: » Assure alignment of Health Plan, CPMG and union leadership to address scope of practice risks, » Identify and prioritize clinical areas at risk for Scope of Practice violations, » Assure clear delineation of accountabilities between practitioners (physicians and allied health professionals) in job descriptions, care delivery documentation, and information systems, » Assure that a process to identify and stay current on scope of practice and related billing laws, regulations, and accreditation standards for all practitioners is in place, » Communicate physician responsibility for assuring the quality of medical services found in care delivery models, clinical guidelines, clinical policies, and quality standards, » Assure that reviews of existing and new care delivery models are conducted, in consultation with Compliance, Risk Management and Legal as appropriate, for scope of practice consideration, and » Assure scope of practice corrective action plans are developed and implemented as appropriate. Region SOP Committee Structure and Process Summary GEORGIA Membership Membership consists of representatives from health plan, medical group, risk management, labor and HR functions for Health Plan and Medical Group. Sponsors are Xx. Xxxxx Xxxxxxx and Xxxxxx Xxxxxx as leaders of the HealthConnect Implementation Project. Reporting » Regional President » TSPMG Medical Director » Chief Compliance Officer Region SOP Committee Structure and Process Summary MID-ATLANTIC STATES Purpose The Committee Will: » Develop and maintain an inventory of scope of practice requirements by position type; » Review and approve protocols, policies and procedures created by the Committee to meet scope of practice regulations and requirements for unlicensed and licensed clinical and support staff; » Develop and oversee implementation of annual scope of practice work plan and action items; » Establish a mechanism for recurring review of clinical position descriptions; » Evaluate existing and proposed clinical practices for scope of practice risks and/or violations and the impact on scope of practice; » Develop and oversee scope of practice training and education throughout the region; » Coordinate with existing committees and work groups to ensure that scope of practice issues are addressed effectively; » Provide recommendations to Committee sponsors and senior leadership regarding identified opportunities for change; » Monitor corrective actions to ensure continued compliance with prescribed scope of practice requirements and regulations; » Collaborate with appropriate departments to ensure that changes are integrated into existing systems, policies and processes; and » Maintain a reporting relationship with the Regional Quality Improvement Committee and the Compliance Department. Reporting to occur not less than quarterly. Subcommittees may be created as needed to facilitate completion of specialized tasks.

Georgia. Purpose » Assure scope of practice review is completed for all applicable clinical staff in health plan and medical group. » Identify and clarify all scope of practice issues identified. » Report findings of scope of practice review to Regional President and Medical Director. » Develop a process and identify accountabilities to assure corrective action plans are developed, implemented, evaluated for effectiveness and monitored over time to assure required practice changes have occurred. Membership Membership consists of representatives from health plan, medical group, risk management, labor and HR functions for Health Plan and Medical Group. Sponsors are Xx. Xxxxx Xxxxxxx and Xxxxxx Xxxxxx as leaders of the HealthConnect Implementation Project. Reporting » Regional President » TSPMG Medical Director » Chief Compliance Officer Region SOP Committee Structure and Process Summary MID-ATLANTIC STATES Purpose The Committee Will: » Develop and maintain an inventory of scope of practice requirements by position type; » Review and approve protocols, policies and procedures created by the Committee to meet scope of practice regulations and requirements for unlicensed and licensed clinical and support staff; » Develop and oversee implementation of annual scope of practice work plan and action items; » Establish a mechanism for recurring review of clinical position descriptions; » Evaluate existing and proposed clinical practices for scope of practice risks and/or violations and the impact on scope of practice; » Develop and oversee scope of practice training and education throughout the region; » Coordinate with existing committees and work groups to ensure that scope of practice issues are addressed effectively; » Provide recommendations to Committee sponsors and senior leadership regarding identified opportunities for change; » Monitor corrective actions to ensure continued compliance with prescribed scope of practice requirements and regulations; » Collaborate with appropriate departments to ensure that changes are integrated into existing systems, policies and processes; and » Maintain a reporting relationship with the Regional Quality Improvement Committee and the Compliance Department. Reporting to occur not less than quarterly. Subcommittees may be created as needed to facilitate completion of specialized tasks.

Georgia. Purpose » Assure scope of practice review is completed for all applicable clinical staff in health plan and medical group. » Identify and clarify all scope of practice issues identified. » Report findings of scope of practice review to Regional President and Medical Director. » Develop a process and identify accountabilities to assure corrective action plans are developed, implemented, evaluated for effectiveness and monitored over time to assure required practice changes have occurred. 2005 Scope of Practice BTG Report, Pages 14 –17 SECTION X: REFERENCES Reference 1: National Compliance Plan Reference 2: Regional Scope of Practice Committee Structure and Process Exhibit 1.C.4.(1) continued Region SOP Committee Structure and Process Summary COLORADO Purpose The purpose of the Scope of Practice Oversight Committee is to provide region-wide monitoring, leadership and oversight for compliance with legal, accreditation and organizational scope of practice requirements. To achieve this purpose, the committee will: » Assure alignment of Health Plan, CPMG and union leadership to address scope of practice risks, » Identify and prioritize clinical areas at risk for Scope of Practice violations, » Assure clear delineation of accountabilities between practitioners (physicians and allied health professionals) in job descriptions, care delivery documentation, and information systems, » Assure that a process to identify and stay current on scope of practice and related billing laws, regulations, and accreditation standards for all practitioners is in place, » Communicate physician responsibility for assuring the quality of medical services found in care delivery models, clinical guidelines, clinical policies, and quality standards, » Assure that reviews of existing and new care delivery models are conducted, in consultation with Compliance, Risk Management and Legal as appropriate, for scope of practice consideration, and » Assure scope of practice corrective action plans are developed and implemented as appropriate. Region SOP Committee Structure and Process Summary GEORGIA Membership Membership consists of representatives from health plan, medical group, risk management, labor and HR functions for Health Plan and Medical Group. Sponsors are Xx. Xxxxx Xxxxxxx and Xxxxxx Xxxxxx as leaders of the HealthConnect Implementation Project. Reporting » Regional President » TSPMG Medical Director » Chief Compliance Officer Region SOP Committee Structure and Process Summary MID-ATLANTIC STATES Purpose The Committee Will: » Develop and maintain an inventory of scope of practice requirements by position type; » Review and approve protocols, policies and procedures created by the Committee to meet scope of practice regulations and requirements for unlicensed and licensed clinical and support staff; » Develop and oversee implementation of annual scope of practice work plan and action items; » Establish a mechanism for recurring review of clinical position descriptions; » Evaluate existing and proposed clinical practices for scope of practice risks and/or violations and the impact on scope of practice; » Develop and oversee scope of practice training and education throughout the region; » Coordinate with re-existing committees and work groups to ensure that scope of practice issues are addressed effectively; Region SOP Committee Structure and Process Summary MID-ATLANTIC STATES Purpose » Provide recommendations to Committee sponsors and senior leadership regarding identified opportunities for change; and » Monitor corrective actions to ensure continued compliance with prescribed scope of practice requirements and regulations; . » Collaborate with appropriate departments to ensure that changes are integrated into existing systems, policies and processes; and processes » Maintain a reporting relationship with the Regional Quality Improvement Committee and the Compliance Department. Reporting to occur not less than quarterly. Subcommittees may be created as needed to facilitate completion of specialized tasks.