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Quality Measurement and Reporting in New York

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Managed care providers in New York must have internal quality assurance mechanisms and comply with the quality assurance standards established by the Commissioner.1 Certified home health agencies, licensed home care services agencies, long term health care programs, AIDS home care programs,2 and hospices must establish quality assurance programs.3

Hospitals must create a quality assurance committee as part of their medical, dental, and podiatric malpractice program4 and must create a program for identifying and tracking hospital acquired infections.5
The Commissioner must conduct quality evaluations of services provided by the child health insurance program 6 and establish quality assurance procedures and performance standards for Accountable Care Organizations.7

The department must collect and disseminate utilization and performance data from hospitals8 and establish a quality reporting system for providers of medical assistance services.9

 

Footnotes

  • 1. NY SOC SERV § 364-j
  • 2. NY PUB HEALTH § 3616-a
  • 3. NY PUB HEALTH § 4011
  • 4. NY PUB HEALTH § 2805-j
  • 5. NY PUB HEALTH § 2511
  • 6. NY PUB HEALTH § 2511
  • 7. NY PUB HEALTH § 2999-q
  • 8. NY PUB HEALTH § 2995-b
  • 9. NY SOC SERV § 364

 

Quality Measurement and Reporting in New York

Subtopic Statute/Regulation Description
Quality reporting requirements – providers and health plans Best Practices for the Patient Safety Center – N.Y. Pub. Health Law § 2998-c The Patient Safety Center must: Review research that will help health care providers and plans identify and improve “systemic problems...
Hospital Acquired Infection Reporting – N.Y. Pub. Health Law § 2819 Every general hospital must maintain a program capable of identifying and tracking hospital acquired infections for the purpose of public reporting...
Requirements for Managed Care Programs – N.Y. Soc. Serv. Law § 364-j New York’s managed care program must provide “comprehensive and coordinated health care delivered in a cost effective manner.”...
Safety Goals of the Patient Safety Center – N.Y. Pub. Health Law § 2998-b The Patient Safety Center must: Develop and disseminate performance information and promote participation by health plans, providers, and...
Quality assessment for health plans Child Health Insurance Plan – N.Y. Pub. Health Law § 2511 Organizations approved by the Commissioner to provide covered health services to children must submit reports and information to the Commissioner...
Performance measurement for health care providers or insurance plans Collection and Utilization of Performance Data and Hospital Report Cards – N.Y. Pub. Health Law § 2995-b The department must collect utilization and performance data through the statewide health information system so that consumers may make informed...
Disclosure of Nursing Quality Indicators – N.Y. Pub. Health Law § 2805-t Every hospital with an operating certificate must make available to the public information regarding nurse staffing and patient outcomes as specified...
Grievance programs (Reporting requirements, Management of grievance reports) Complaint Investigation Procedures – N.Y. Soc. Serv. Law § 461-o The department must create procedures for receiving and investigating complaints about adult care facilities. These procedures must ensure that the...
Disclosure of Nursing Quality Indicators – N.Y. Pub. Health Law § 2805-t Every hospital with an operating certificate must make available to the public information regarding nurse staffing and patient outcomes as specified...
Provider Requirements – N.Y. Comp. Codes R. & Regs. tit. 14, § 815.4 Requirements for Providers of Chemical Dependency Services The law protects the rights of patients seeking chemical dependency services by...
Requirements and Duties of Providers of Services to the Mentally Disabled – N.Y. Mental Hyg. Law § 31.11 Every provider of services to the mentally disabled must comply with the following requirements: Notify the district attorney or other...
Requirements for Hospital-Based Medical, Dental and Podiatric Malpractice Prevention Programs – N.Y. Pub. Health Law § 2805-j Hospitals must have a medical, dental, and podiatric malpractice program for the purpose of identifying and preventing malpractice. These malpractice...
Quality assurance programs for hospitals or public programs Department Responsibility for Standards for Medical Assistance Payments to Providers and Quality Reporting of Providers – N.Y. Soc. Serv. Law § 364 Department Responsibility for Standards for Medical Assistance Payments to Providers and Quality Reporting of Providers This section falls under...
Quality Assurance Requirements for Certified Home Health Agencies, Licensed Home Care Services Agencies, Long Term Health Care Programs, and AIDS Home Care Programs – N.Y. Pub. Health Law § 3616-a Certified home health agencies, licensed home care services agencies, long term health care programs and AIDS home care programs (“entities...
Quality Assurance Requirements – N.Y. Pub. Health Law § 4011 Hospices must create quality assurance programs in order to evaluate the quality of provided services.    Quality assurance information...
Requirements for Establishing Regulations for Accountable Care Organizations – N.Y. Pub. Health Law § 2999-q The Commissioner must establish regulations for Accountable Care Organizations after consulting with providers, payers, and other interested...
Quality Measurement and Reporting N.Y. Comp. Codes R. & Regs. tit. 14 § 584.17 - Quality Assurance at Residential Treatment Facilities for Children and Youth with Mental Disabilities This regulation sets forth the requirements for ensuring quality at residential treatment facilities for children and youth with mental disabilities...
N.Y. Comp. Codes R. & Regs. tit. 14 § 589.10 - Quality Assurance at Crisis Residence Programs for Mentally Ill This regulation sets forth the requirements for ensuring quality at crisis residence programs for the mentally ill.  The regulation requires...
N.Y. Comp. Codes R. & Regs. tit. 14 § 594.14 - Quality Assurance at Licensed Housing Programs for Children and Adolescents with Serious Emotional Disturbances This regulation requires that each provider of service at licensed housing programs for children and adolescents with serious emotional disturbances...
N.Y. Comp. Codes R. & Regs. tit. 14 § 595.13 - Quality Assurance at Residental Programs for Adults with Mental Illness This regulation requires that each provider of service at residential programs for adults with mental illness have a quality assurance plan in place...
Reporting, Use and/or Confidentiality of quality data (Cross reference Privacy & Confidentiality) Quality Assurance Requirements – N.Y. Pub. Health Law § 4011 Hospices must create quality assurance programs in order to evaluate the quality of provided services.    Quality assurance information...
Click on the individual state law in the table above to see our summary of the individual law.


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