1. (1) At the commissioner's request, the health carrier shall provide documentation on its quality improvement activities and an evaluation of the effectiveness of the previous year's quality improvement activities. Such documentation must include the health carrier's identification of quality assessment problems and opportunities for improving care through:

   1. (a) ongoing monitoring of process, structure, and outcomes of patient care or clinical performance;
   2. (b) evaluation of the data collected from ongoing monitoring activities to identify problems in patient care or clinical performance using criteria developed and applied by health care professionals;
   3. (c) measurable objectives for each improvement action within the reporting year, including the degree of expected change in persons or situations;
   4. (d) time frames for quality improvement action; and
   5. (e) parties responsible for implementing quality improvement action.

Authorizing statute(s): 33-36-105, MCA

Implementing statute(s): 33-36-105, 33-36-303, MCA

History: NEW, 2001 MAR p. 1342, Eff. 7/20/01; TRANS, from 37.108.510, 2023 MAR p. 1403, Eff. 1/1/24; AMD, 2024 MAR p. 714, Eff. 4/13/24.