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 350. Quality assurance program
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A. As it pertains to the covered persons, the MCHIP licensee shall integrate monitoring of the delegated service entity with respect to the following activities within its quality assurance program:
1. Quality assurance program activities;
2. Quality assurance plan measures; and
3. Complaint and appeals processes.
B. When the MCHIP's licensee's expectations have not been met, the MCHIP licensee shall require the delegated service entity to provide:
1. A corrective action plan that addresses areas where performance expectations have not been met; and
2. Evidence that corrective action was taken in keeping with corrective action plans.
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.