The quality management program required by section 2 of this chapter must include at least the following:
- (1) A written statement of the scope and purpose of the health maintenance organization's quality management program, including a written statement of goals and objectives that emphasizes improved health status in evaluating the quality of care rendered to enrollees.
- (2) The organizational structure responsible for quality management activities.
- (3) Any contractual arrangements, when appropriate, for delegation of quality management activities.
- (4) Confidentiality of policies and procedures.
- (5) A system of ongoing evaluation activities.
- (6) A system of focused evaluation activities.
- (7) A system for credentialing providers and performing peer review activities.
- (8) Duties and responsibilities of the designated physician responsible for the quality management activities.
As added by P.L.26-1994, SEC.25.