Quality, Monitoring and Oversight
The Plan will regularly monitor Enhanced Care Management (ECM) provider performance and compliance with ECM requirements using a variety of methods which may include monitoring calls, onsite visits, progress reports, audits and/or corrective actions, as needed.
The ECM provider acknowledges that the Plan will conduct oversight of its participation in ECM to ensure the quality of ECM and ongoing compliance with program requirements using the modalities listed above. The ECM provider must respond to all the Plan requests for information and documentation to permit ongoing monitoring of ECM.