Virginia Administrative Code (Last Updated: January 10, 2017) |
Title 12. Health |
Agency 5. Department of Health |
Chapter 408. Certificate of Quality Assurance of Managed Care Health Insurance Planlicensees |
Section 310. Data collection and submission
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A. Data collected and analyzed for clinical service evaluation shall be:
1. From the covered person population areas appropriate for the MCHIP to assess including: (i) high risk and high volume areas, (ii) areas where clinical problems are expected or have occurred in the past, (iii) areas that have the potential for adverse health outcomes, and (iv) areas where preventive health measures may have an impact;
2. Collected using processes that are methodologically sound;
3. Valid, reliable, complete and timely;
4. Analyzed quantitatively by personnel qualified to evaluate the data for clinical quality improvement; and
5. Protected for confidentially, easily retrievable, and transmitted for appropriate release to external parties.
B. The MCHIP licensee may permit appropriate organizations with which it contracts to collect and analyze relevant performance evaluation data and to release that data to the department or to its designee.
Historical Notes
Derived from Volume 16, Issue 07, eff. January 20, 2000; amended, Virginia Register Volume 18, Issue 08, eff. January 30, 2002.
Statutory Authority
§ 32.1-137.1 of the Code of Virginia.