Quality Assurance and Quality Improvement Strategies

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The commissioner shall develop and implement quality assurance and quality improvement strategies to ensure the quality of long-term care services provided pursuant to this part and shall specify in contractor risk agreements with contractors responsible for coordination of medicaid primary, acute and long-term care services requirements related to the quality of long-term care services provided. The strategies may include the use of electronic visit verification for data collection and reporting, HEDIS measures pertaining to long-term care services, and shall include mechanisms to ensure direct feedback from members and family or other caregivers regarding the quality of services received. The commissioner shall ensure that recipients of long-term care services are notified how to contact the bureau of TennCare if they have concerns about the long-term care services they are or are not receiving and the process for resolving such issues.


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