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Managed Care Nursing

Category - Healthcare Management

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Identify the statement that does not reflect one of the three mandatory, federally regulated Medicaid External Quality Review (EQR) activity protocols.

Assessment of compliance with Medicaid MCO and PHIP regulations
Validation of Performance Measures reported by MCO and PHIP
Create and distribute performance improvement projects based on data outcomes
Validation of MCO and PHIP performance improvement projects
None of the above

Explanation

Answer: C - Creating and distributing performance improvement projects based on data outcomes is not one of the three mandatory, federally regulated Medicaid EQR activity protocols.

The three mandatory, federally regulated Medicaid EQR activity protocols include assessment of compliance with Medicaid MCO and PHIP regulations, Validation of Performance Measures and improvement projects reported by MCO and PHIP.

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Managed Care Nursing

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