Compliance and Quality Reports

Compliance Summary Report

The Compliance Summary Report contains information for MSHN internal audits and external audits.  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 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.

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 effectivness 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.