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007.05.1-XIX. EXTERNAL QUALITY ASSURANCE/IMPROVEMENT ASSESSMENT.

AR ADC 007.05.1-XIXArkansas Administrative Code

West's Arkansas Administrative Code
Title 007. Department of Health
Division 05. Health Facility Services
Rule 1. Rules and Regulations for Health Maintenance Organizations in Arkansas
Ark. Admin. Code 007.05.1-XIX
007.05.1-XIX. EXTERNAL QUALITY ASSURANCE/IMPROVEMENT ASSESSMENT.
Currentness
A. When the Department determines that a significant quality problem exists that is not being addressed internally, that HMO shall have an external QA/I assessment performed. Such external assessment shall study the quality of care being provided to Enrollees and the effectiveness of the QA/I program established by the HMO.
B. The assessment shall be conducted by a person or persons hired by the HMO and not involved in the operation or direction of the HMO or in the delivery of Health Care Services to its Enrollees.
C. The person or persons hired shall be an individual or organization with recognized experience in the appraisal of medical practice and quality assurance in an HMO setting.
D. The person or persons hired shall be approved by the Director and shall report at frequent intervals to Department representatives during the assessment period.
E. The person or persons hired shall issue a written report of findings to the HMO's governing body. A copy of this report shall be submitted to the Director within ten (10) business days of its receipt by the HMO.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 007.05.1-XIX, AR ADC 007.05.1-XIX
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