Chis: Quality Assurance

The Department will establish performance criteria to meet federal assurances that measure the outcomes and effectiveness of CHIS. (7-1-26) 01. Quality Assurance. Quality assurance reviews assure compliance with the Department's rules and regulations for CHIS. Identified problems that impact health and safety or are not resolved through quality improvement activities, will have implementation of a corrective action process. (7-1-26) 02. Quality Improvement. Activities may include any of the following: (7-1-26) a. Consultation; (7-1-26) b. Technical assistance and recommendations; or (7-1-26) c. A Corrective Action. A formal process used by the Department to address significant, ongoing, or unresolved deficient practices identified during the review process under these rules. Corrective action includes: (7-1-26) i. Issuance of a corrective action plan; (7-1-26) ii. Reporting to Medicaid Program Integrity Unit; or (7-1-26) iii. Action against a provider agreement. (7-1-26) 187. – 189. (RESERVED) SUB AREA: PREVENTION SERVICES (Sections 190-199)