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Mich. Admin. Code r. 325.6601 - Quality assurance program; conduct; contents

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Each insurer or health plan must have a quality assurance program in place that is approved by the Department of Community Health.  The quality assurance program must include the following:

  • specify the role of the medical director
  • monitor, review, and evaluate the quality of health care services provided
  • standards against which quality can be measured
  • ways to ensure that data is collected from the total enrolled population
  • methodology for routine reporting of quality assurance activities
  • provisions to remedy areas where there are quality deficiencies
  • provisions to reevaluate areas that were previously not up to standard.

Current as of June 2015