Services are delivered in Percent of new participants Data source: Person-centered accordance with the receiving services according Plan record reviews financial service Plan, including the to their POC within 45 days of records. type, scope, amount, approval of their POC. Data collection responsible duration, and frequency party: MCO. specified in the service Frequency of data collection: Percent of participants who plan. Quarterly. received services in the type, Sampling: Representative amount, duration, and sample, 95% CI. frequency specified in the Data aggregation responsible POC. party: MCO. Frequency of data aggregation and analysis: Semiannually. Participants are afforded Percent of participant records Data source: Record reviews, choice between/among reviewed with a completed, onsite. waiver services and signed freedom of choice Data collection responsible providers. form that specifies choice party: MCO. was offered among waiver Frequency of data collection: services and providers. Continuously and ongoing. Sampling: Representative Percent of participants sample, 95% CI. reviewed with a POC that includes the participant's Data aggregation responsible and/or guardian/caregiver's party: MCO and DOH. signature as consistent with Frequency of data aggregation state and federal guidelines. and analysis: Semi-annually. 4 Qualified providers: The State verifies that Percent of waiver providers Data source: MCO credentialing Providers meet required providers initially and providing waiver services files. qualifications. continually meet required who meet licensure and Data collection responsible licensure and/or certification requirements party: MCO. certification standards and prior to furnishing waiver Frequency of data collection: adhere to other standards services initially. Continuously and ongoing. —
Services are delivered in accordance with the service Plan, including the type, scope, amount, duration, and frequency specified in the service plan. Percent of new participants receiving services according to their POC within 45 days of approval of their POC. Percent of participants who received services in the type, amount, duration, and frequency specified in the POC. Data source: Person-centered Plan record reviews financial records. Data collection responsible party: MCO. Frequency of data collection: Quarterly. Sampling: Representative sample, 95% CI. Data aggregation responsible party: MCO. Frequency of data aggregation and analysis: Semiannually. Participants are afforded choice between/among waiver services and providers. Percent of participant records reviewed with a completed, signed freedom of choice form that specifies choice was offered among waiver services and providers. Percent of participants reviewed with a POC that includes the participant's and/or guardian/caregiver's signature as consistent with state and federal guidelines. Data source: Record reviews, onsite. Data collection responsible party: MCO. Frequency of data collection: Continuously and ongoing. Sampling: Representative sample, 95% CI. Data aggregation responsible party: MCO and DOH. Frequency of data aggregation and analysis: Semi-annually. 4 Qualified providers: Providers meet required qualifications. The State verifies that providers initially and continually meet required licensure and/or certification standards and adhere to other standards Percent of waiver providers providing waiver services who meet licensure and certification requirements prior to furnishing waiver services — initially. Data source: MCO credentialing files. Data collection responsible party: MCO. Frequency of data collection: Continuously and ongoing.
expedited-rest-state-rfq.docx