IQIP Requirements, Control Process, and Reporting

13010 - IQIP Requirements, Control Process, and Reporting (Rev. 23, Issued: 12-03-15, Effective: 12-03-15, Implementation; 12-03-15) Every QIO shall document and implement an IQIP that encompasses the tasks, subtasks, major activities, deliverables, reporting, and contract administrative functions such as financial management defined in its contract with CMS. IQIPs must address the following requirements, and each QIO must implement internal quality control processes that strengthen performance of the work identified in its QIO contract: • Identify tasks, subtasks, and/or activities that are included • Identify measures and/or monitors of performance for each of the tasks, subtasks, and/or activities • Identify plans for how the QIO will meet goals and targets • Implement control measures that enable the QIO to determine if performance is proceeding acceptably during the course of the contract to enable the QIO to adjust course when necessary and meet intermediate and/or process goals or targets that the QIO has set for identified tasks, subtasks, and/or activities and evaluation targets specified in the contract • At least quarterly, or more often as performance indicates or as otherwise directed, use measures, results, and other information to assess whether the QIO is likely to meet goals and targets. Analyze any causes of failure and propose and implement changes in the process(es) that the QIO believes will improve performance • Maintain documentation of: o Measures, thresholds, measurement timeframes o Results of measurement o Method(s) used to analyze causes of failure and results of the analysis o Proposed and selected process improvements that address the causes of failure o Implementation of improvement actions and their impact o Communication of results and actions • Assess whether improvements were successful and make adjustments to the process, if needed When requested by CMS, QIOs shall report and make available documentation of the QIO’s continuous internal quality improvement process controls including measurements, monitoring, plan, results, improvement actions, and lessons learned for all tasks, subtasks, and major activities. DOCUMENTATION AND RECORD RETENTION