58-17G-4. Health carrier issuing closed plan to develop quality improvement activities--Minimum requirements of quality improvement activities.
Any health carrier that issues a closed plan, or a combination plan having a closed component, shall, in addition to complying with the requirements of §58-17G-3, develop and maintain the internal structures and activities necessary to improve the quality of care being provided. Quality improvement activities for a health carrier subject to the requirements of this section shall involve:
(1)Developing a written quality improvement plan designed to analyze both the processes and outcomes of the health care delivered to covered persons;
(2)Establishing an internal system to implement the quality improvement plan and to specifically identify opportunities to improve care and using the findings of the system to improve the health care delivered to covered persons; and
(3)Assuring that participating providers have the opportunity to participate in developing, implementing, and evaluating the quality improvement system.
The health carrier shall provide a copy of the quality improvement plan to the director or secretary, if requested. (SL 2012, ch 239, §1 provides: "The provisions of chapter 219 of the 2011 Session Laws shall be deemed repealed if the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010), as amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, 124 Stat. 1029 (2010) is found to be unconstitutional in its entirety by a final decision of a federal court of competent jurisdiction and all appeals exhausted or time for appeals elapsed.")
Source: SL 2011, ch 219, §24.