Texas § GV.546.0504 - QUALITY MONITORING BY EXTERNAL QUALITY REVIEW ORGANIZATION

§ GV.546.0504. QUALITY MONITORING BY EXTERNAL QUALITY REVIEW ORGANIZATION

QUALITY MONITORING BY EXTERNAL QUALITY REVIEW ORGANIZATION. The commission, based on the state's external quality review organization's initial report on the STAR Kids managed care program, shall determine whether the findings of the report necessitate additional data and research to improve the program. If the commission determines additional data and research are needed, the commission, through the external quality review organization, may: (1) conduct annual surveys of recipients receiving benefits under the medically dependent children (MDCP) waiver program, or their representatives, using the Consumer Assessment of Healthcare Providers and Systems; (2) conduct annual focus groups with recipients described by Subdivision (1) or their representatives on issues identified through: (A) the Consumer Assessment of Healthcare Providers and Systems; (B) other external quality review organization activities; or (C) stakeholders; and (3) in consultation with the STAR Kids Managed Care Advisory Committee and as frequently as feasible, calculate Medicaid managed care organizations' performance on performance measures using available data sources such as the collaborative innovation improvement network. Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611 ), Sec. 1.01, eff. April 1, 2025.