Indiana § 27-13-6-3 Quality management program requirements

Indiana Statutes

§ 27-13-6-3 — Quality management program requirements

Indiana·Title 27 INSURANCE·Art. 13 HEALTH MAINTENANCE ORGANIZATIONS·Ch. 6 Quality Management Programs

The quality management program required by section 2 of this chapter must include at least the following:

(1)A written statement of the scope and purpose of the health maintenance organization's quality management program, including a written statement of goals and objectives that emphasizes improved health status in evaluating the quality of care rendered to enrollees.

(2)The organizational structure responsible for quality management activities.

(3)Any contractual arrangements, when appropriate, for delegation of quality management activities.

(4)Confidentiality of policies and procedures.

(5)A system of ongoing evaluation activities.

(6)A system of focused evaluation activities.

(7)A system for credentialing providers and performing peer review activities.

(8)Duties and responsi

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The quality management program required by
section 2 of this chapter must include at least the following:
(1) A written statement of the scope and purpose of the health
maintenance organization's quality management program,
including a written statement of goals and objectives that
emphasizes improved health status in evaluating the quality of
care rendered to enrollees.
(2) The organizational structure responsible for quality
management activities.
(3) Any contractual arrangements, when appropriate, for
delegation of quality management activities.
(4) Confidentiality of policies and procedures.
(5) A system of ongoing evaluation activities.
(6) A system of focused evaluation activities.
(7) A system for credentialing providers and performing peer
review activities.
(8) Duties and responsibilities of the designated physician
responsible for the quality management activities.