Quality Measurement and Reporting in Iowa
Quality Measurement and Reporting in Iowa
| Subtopic | Statute/Regulation | Description |
|---|
| Grievance programs (Reporting requirements, Management of grievance reports) | Complaint System, Iowa Code § 514B.14 | Complaint System Requires Health Maintenance Organizations to establish a system for complaints that has received approval from the... |
| Complaints, I.A.C. r. 191-40.9 | Complaints Requires health maintenance organizations to establish a system for resolving complaints. Requires HMOs to maintain records of... | |
| Grievance Procedures, I.A.C. r. 441-88.8 | Grievance Procedures Requires prepaid health plans (PHPs) to establish grievance procedures and to obtain the Department of Human Services... | |
| Grievances, I.A.C. r. 441-73.15 | Grievances Requires managed care organizations that provide Medicaid services to establish procedures for handling nonclinical grievances.... | |
| Written Record, I.A.C. r. 441-73.16 | Written record Requires managed care organizations to maintain records of received grievances and their disposition and report these records... |
| Quality assurance programs for hospitals or public programs | Continuous Quality Improvement Program, I.A.C. r. 657-8.26 | Continuous quality improvement program Requires pharmacies to establish a continuous quality improvement program as a means of... |
| Iowa Newborn Screening Program (INSP), I.A.C. r. 641-4.3 | Iowa Newborn Screening Program (INSP) Establishes standards and procedures for the Iowa newborn screening program. Requires all newborns in... | |
| Participating Health and Dental Plans, I.A.C. r. 441-86.15 | Participating Health and Dental Plans Establishes requirements for health and dental plans that wish to participate in Iowa’s CHIP... | |
| Quality Assurance, I.A.C. 641-21.7 | Quality Assurance Requires hospitals to allow the Department of Health to inspect medical records related to the brain and spinal cord injury... | |
| Quality assurance, I.A.C. r. 441-73.24 | Quality Assurance Requires managed care organizations that provide Medicaid services to implement a systems for quality assurance and... | |
| Stroke Care, Iowa Code § 135.191 | Stroke Care -- continuous quality improvement. Requires the Department of Public Health to maintain a statewide stroke database.... |
| Quality reporting requirements – providers and health plans | Health Home Services Providers, I.A.C. r. 441-77.47 | Health Home Services Providers Establishes qualifications for health home services providers’ participation in Iowa’s Medicaid... |
| External review for insurance and/or peer review purposes (Cross reference to Private Insurance Data and Medical Peer Review) | Quality of Care, I.A.C. r. 191-40.5 | Quality of Care Establishes quality of care requirements for health maintenance organizations. These requirements include maintaining a... |
| Quality assessment for health plans | Quality of Care, I.A.C. r. 191-40.5 | Quality of Care Establishes quality of care requirements for health maintenance organizations. These requirements include maintaining a... |
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