Revisions to Chapter 5, “Quality Improvement.”
This chapter captures changes which resulted once the
Medicare Prescription Drug, Improvement and Modernization Act of 2003 was enacted.
It details the requirements of the Quality Improvement Program that the Medicare
Advantage Organizations (MA organization) must meet and the applicable timelines.
Each MA organization must conduct quality improvement projects that include the entire
organization, and focus on both clinical and non-clinical areas. Additionally, the levels of
accreditation for health organizations are outlined as well as the monitoring role of CMS.
References to Medicare + Choice (M + C) is changed to Medicare Advantage (MA), and
Quality Assessment and Performance Improvement (QAPI) is changed to Quality
Improvement (QI).
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 20, 2006
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.