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Chapter 543A

Quality-Based Outcomes and Payments under Medicaid and Child Health Plan Program

Subchapter A. General Provisions

543A.0001 Definitions 543A.0002 Development of Outcome and Process Measures; Correlation with Increased Reimbursement Rates 543A.0003 Use of Quality-Based Outcome Measure for Enrollees or Recipients with Hiv Infection 543A.0004 Development of Quality-Based Payment Systems 543A.0005 Payment Methodology Conversion 543A.0006 Transparency; Considerations 543A.0007 Periodic Evaluation 543A.0008 Biennial Report

Subchapter B. Quality-Based Payments Relating to Managed Care Organizations

543A.0051 Quality-Based Premium Payments; Performance Reporting 543A.0052 Financial Incentives and Contract Award Preferences

Subchapter C. Quality-Based Health Home Payment Systems

543A.0101 Definition 543A.0102 Quality-Based Health Home Payments 543A.0103 Health Home Eligibility

Subchapter D. Quality-Based Hospital Reimbursement System

543A.0151 Collecting Certain Information; Reports to Certain Hospitals 543A.0152 Reimbursement Adjustments

Subchapter E. Quality-Based Payment Initiatives

543A.0201 Payment Initiatives; Determination of Benefit to State 543A.0202 Payment Initiative Administration 543A.0203 Quality-of-Care and Cost-Efficiency Benchmarks and Goals; Efficiency Performance Standards 543A.0204 Payment Rates under Payment Initiatives

Subchapter F. Quality-Based Long-Term Services and Supports Payment Systems

543A.0251 Quality-Based Payment Systems for Long-Term Services and Supports 543A.0252 Data Set Evaluation 543A.0253 Collecting Certain Information; Reports to Certain Providers