Sec. 4. The quality management program required by section 2 of this chapter must contain a written statement describing the system of ongoing quality management activities, including the following:
(1) Problem assessment, identification, selection, and study.
(2) Corrective action, monitoring, evaluation, and reassessment.
(3) Interpretation and analysis of patterns of care rendered to individual patients by individual providers.
(4) Comparison between patterns of care, including outcomes, rendered to patients by providers and the cost to the health maintenance organization of that care.
(5) A written statement describing the system of focused quality assurance activities based on representative samples of the enrolled population that identifies method of topic selection, study, data collection, analysis, interpretation, and report format.
As added by P.L.26-1994, SEC.25.
Structure Indiana Code
Article 13. Health Maintenance Organizations
Chapter 6. Quality Management Programs
27-13-6-1. Procedures; Establishment
27-13-6-2. Internal Quality Management Program Required
27-13-6-3. Quality Management Program Requirements
27-13-6-4. Written Statement of Quality Management Activities
27-13-6-5. Written Plans for Correcting Insufficient Service
27-13-6-6. Patient Record System
27-13-6-7. Reporting Quality Management Program Activities
27-13-6-8. Records of Proceedings; Confidentiality