Quality Measurement and Improvement; External Quality Review

  1. Law
  2. CFR 42
  3. Public Health
  4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
  5. Medical Assistance Programs
  6. Managed Care
  7. Quality Measurement and Improvement; External Quality Review

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Section
438.310

Basis, scope, and applicability.

Section
438.320

Definitions.

Section
438.330

Quality assessment and performance improvement program.

Section
438.332

State review of the accreditation status of MCOs, PIHPs, and PAHPs.

Section
438.334

Medicaid managed care quality rating system.

Section
438.340

Managed care State quality strategy.

Section
438.350

External quality review.

Section
438.352

External quality review protocols.

Section
438.354

Qualifications of external quality review organizations.

Section
438.356

State contract options for external quality review.

Section
438.358

Activities related to external quality review.

Section
438.360

Nonduplication of mandatory activities with Medicare or accreditation review.

Section
438.362

Exemption from external quality review.

Section
438.364

External quality review results.

Section
438.370

Federal financial participation (FFP).