The Maryland Department of Health looks at the Managed Care Organizations. They review the quality of care given to Medicaid members. The Maryland Department of Health makes sure the care meets regulations. An outside agency does the review. It is called a Systems Performance Review. It looks at our quality improvement program. It also looks at the process and outcomes our organization. The Systems Performance Review has 11 areas.
- Quality Improvement
- Accountability to the Governing Body
- Oversight of Delegated Entities
- Credentialing and Recredentialing
- Enrollee Rights
- Availability and Accessibility
- Utilization Review
- Continuity of Care
- Health Education
- Fraud and Abuse
At MedStar Family Choice all departments are part of our quality improvement program. We think this is important. It helps us provide you quality care. We want to make sure you receive the highest level of care.