HCA 375 quiz 1-05

Question 5 1/1pts Federal regulations require that states who contract with Medicaid managed care organizations (MCO) or Prepaid Inpatient Health Plans (PIHP) do which of the following? Review credentialing and board certfications for all physicians providing care to Medicaid recipie Analyze inpatient data to Review malpractice claims submitted on the behalf of Medicaid ‘Conduct an extemal quaity review of each entity to ensure itis providing qualty care. The answer can be found in Section 1.3, State Efforts in Principles of Healthcare Quality Management: Tools and Applications.