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 form Data collection responsible providers. that specifies choice was party: MCO. 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 who files. qualifications. continually meet required meet licensure and Data collection responsible licensure and/or certification requirements prior party: MCO. certification standards and to furnishing waiver services Frequency of data collection: adhere to other standards initially. Continuously and ongoing. — prior to their furnishing Sampling: 100% review. waiver services. Percent of waiver providers Data aggregation responsible providing waiver services who party: MCO. meet licensure and Frequency of data aggregation certification requirements prior and analysis: Quarterly. to furnishing waiver services continuously. Note: The State and CMS may — want the data stratified by Percent of waiver providers licensed, certified and atypical to providing waiver services who ensure that they can pinpoint have an active agreement deficiencies in MCO
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 prior to their furnishing waiver services. Percent of waiver providers providing waiver services who meet licensure and certification requirements prior to furnishing waiver services — initially. Percent of waiver providers providing waiver services who meet licensure and certification requirements prior to furnishing waiver services — continuously. Percent of waiver providers providing waiver services who have an active agreement Data source: MCO credentialing files. Data collection responsible party: MCO. Frequency of data collection: Continuously and ongoing. Sampling: 100% review. Data aggregation responsible party: MCO. Frequency of data aggregation and analysis: Quarterly. Note: The State and CMS may want the data stratified by licensed, certified and atypical to ensure that they can pinpoint deficiencies in MCO
final-rfq.docx