Responsible Party for Frequency of data Sampling Approach data collection/generation: (check each that collection/generation (check each that applies) (check each that applies) applies) State Medicaid Agency Weekly 100% Review Operating Agency Monthly Less than 100% Review Sub-State Entity Quarterly Representative Sample; Confidence Interval = Other Annually Specify: Administrative Services Continuously and Stratified: Describe Organization Ongoing Group: Other Specify: Other Specify: Add another Data Source for this performance measure Data Aggregation and Analysis Responsible Party for Frequency of data data aggregation and aggregation and analysis analysis: (check each that (check each that applies applies State Medicaid Agency Weekly Operating Agency Monthly Sub-State Entity Quarterly Other Annually Specify: Continuously and Ongoing Other Specify: b Sub-Assurance: The State monitors non-licensed/non-certified providers to assure adherence to waiver requirements. i. Performance Measures For each performance measure the State will use to assess compliance with the statutory assurance complete the following. Where possible, include numerator/denominator.
Responsible Party for data collection/generation (check each that applies) Frequency of data collection/generation: (check each that applies) Sampling Approach (check each that applies) State Medicaid Agency Weekly 100% Review Operating Agency Monthly Less than 100% Review Sub-State Entity Quarterly Representative Sample; Confidence Interval = Other Specify: Annually Administrative Services Organization Continuously and Ongoing Stratified: Describe Group: Other Specify: Other Specify: Add another Data Source for this performance measure Data Aggregation and Analysis Responsible Party for data aggregation and analysis (check each that applies Frequency of data aggregation and analysis: (check each that applies State Medicaid Agency Weekly Operating Agency Monthly Sub-State Entity Quarterly Other Specify: Annually Continuously and Ongoing Other Specify: b Sub-Assurance: The State monitors non-licensed/non-certified providers to assure adherence to waiver requirements. i. Performance Measures For each performance measure the State will use to assess compliance with the statutory assurance complete the following. Where possible, include numerator/denominator.
ABI-RH%20Renewal%20Application-Clean%20draft-October%202017.docx