External Quality Review of Medicaid MCOs and Supporting Regulations in 42 CFR 438.360, 438.362, and 438.364

EQR PROTOCOL 1 – ASSESSING MCO COMPLIANCE WITH MEDICAID
MANAGED CARE REGULATIONS
Attachment C: Sample Site Visit Agenda
The purpose of the Agenda is to assure that all parties understand the purpose of the site visit and what
will occur during the compliance sessions. The EQRO should prepare the Agenda and send it in advance
to the individual representing the MCO in the Protocol 1 regulatory compliance review process. The MCO
representative will be responsible for identifying the additional MCO participants who will contribute to
each of the sessions. The agenda will also provide the locations where the meetings will occur. The
number of days for the site visit will be determined by the EQRO based upon the estimated duration and
number of meetings required to carry out the site visit. At the end of each day, the EQRO will lead a
concluding meeting to discuss any outstanding information and answer any questions. At the end of the
final day, the EQRO will provide concluding remarks and identify next steps in the review process.
EQRO Site Visit Agenda
Introduction of Participants
Purpose of Meeting: To clarify MCO compliance with Protocol 1 Regulations
Activities Day 1: Several Meetings will be held during the two-day period
Time
(EQRO)

Regulatory Issue
(EQRO)

Location
(MCO)

Participants
(BOTH)

Comments/ Documents
(EQRO)

*The organization responsible for completing each part of the agenda is identified above in parenthesis.

Final Meeting Day 1: Outstanding Issues from the first day
Questions by either EQRO or MCO
Activities Day 2:
Time
(EQRO)

Regulatory Issue
(EQRO)

Location
(MCO)

Participants
(BOTH)

Comments/ Documents
(EQRO)

*The organization responsible for completing each part of the agenda is identified above in parenthesis.

Final Meeting Day 2: Concluding Issues and Comments
Description of next steps in the process
Exit Meeting Day: Discussion of problematic findings to clarify reviewer understanding

EQR Protocol 1 Attachment C
Sample Site Visit Agenda
December 2011

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