Compliance and Quality Reports

Compliance Summary Report

The Compliance Summary Report contains information for MSHN internal audits, external audits, and activities carried out as part of the Compliance Plan.  The internal audits are completed by MSHN and include the Delegated Managed Care reviews for the Provider Network. The external audits are completed by the Michigan Department of Health and Human Services (MDHHS) and the Health Services Advisory Group (HSAG).  The reviews completed by MDHHS include the HSW Waiver review, Substance Use Disorder review and Autism review.  The reviews completed by HSAG include the Performance Measure Validation review, Performance Improvement Project and Compliance Monitoring review.

• Compliance Annual Summary Report

Quality Assessment and Performance Improvement Program (QAPIP) Plan and Annual Report

The State of Michigan requires each Prepaid Inpatient Health Plan (PIHP) to have a Quality Assessment and Performance Improvement Program which meets the standards based upon the Guidelines for Internal Quality Assurance Programs; the Balanced Budget Act of 1997; Public Law 105-33; and 42 Code Of Federal Regulations.  The QAPIP Plan includes an adequate structure which allows for clear and appropriate administration and evaluation of the QAPIP; the components and activities of the QAPIP;  the role for recipients of service in the QAPIP; and the mechanisms or procedures to be used for adopting and communicating process and outcome improvement.

The QAPIP Annual Report is an effectiveness review of the components of the QAPIP, including performance measures, improvement initiatives, strategic initiatives, as well as a description of the work completed by MSHN’s councils, committees and workgroups.

•  QAPIP Report and Plan Executive Summary
•  QAPIP Annual Plan
•  QAPIP Annual Report
  • Attachment 1 - QAPIP Communication
  • Attachment 2 - MMBPIS Performance Summary
  • Attachment 3 - Integrated Health Report
  • Attachment 4 - PIP #1 - Access - Reduction of Disparities Monitoring Report
  • Attachment 5 - PIP #2- Penetration Rate Report
  • Attachment 6 - Critical Incident Performance Report
  • Attachment 7 - Critical Incident Process Improvement Summary Report
  • Attachment 8 - Critical Incident Performance Report SUDTP
  • Attachment 9 - Behavior Treatment Review Data
  • Attachment 10 - Executive Summary Member Experience of Care Report
  • Attachment 11 - MSHN National Core Indicator Summary
  • Attachment 12 - ACT Utilization Report
  • Attachment 13 - Behavioral Health Department Quarterly Report
  • Attachment 14 - Service Authorization Denial Report
  • Attachment 15 - QAPI Compliance Summary Report
  • Attachment 16 - Governing Body Form