Requirements for Provision of Data by Health Maintenance Organizations - Mo. Rev. Stat. §192.068

All health maintenance organizations (HMOs) are required to provide data on quality of care, access to care, member satisfaction, and health status to the Department of Health and Senior Services.  An HMO’s failure to submit the information may subject the organization to penalties.  Continuous failure to submit information to the Department may subject the HMO to exclusion from state funded programs. 

The Department must specify the types of data to be submitted to measure care quality and access and member satisfaction.  The Department may use HEDIS measures, standards developed by the National Committee on Quality Assurance, or other data.  Data submitted to the Department is not public information, however reports prepared by the Department are public information.  The Department may not use data that could identify a patient.  The Department may perform studies and publish information, including a consumer guide annually.