438.350—State responsibilities.

Each State that contracts with MCOs or PIHPs must ensure that—

(a) Except as provided in § 438.362, a qualified EQRO performs an annual EQR for each contracting MCO or PIHP;

(b) The EQRO has sufficient information to use in performing the review;

(c) The information used to carry out the review must be obtained from the EQR-related activities described in § 438.358.

(d) For each EQR-related activity, the information must include the elements described in § 438.364(a)(1)(i) through (a)(1)(iv);

(e) The information provided to the EQRO in accordance with paragraph (c) of this section is obtained through methods consistent with the protocols established under § 438.352; and

(f) The results of the reviews are made available as specified in § 438.364.

CFR

438.350—State responsibilities.